DR. LAURIE R MALLIS (NPI# 1871628800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871628800 |
| Entity Type | Individual |
| Full Name | DR. LAURIE R MALLIS |
| Credential | MD |
| Practice Address |
801 Co Op City Blvd Bronx NY 10475-1603 |
| Mailing Address |
147 Devon Farms Rd Stormville NY 12582-5269 |
| Practice Telephone | 7182396500 |
| Mailing Fax Number | 8452272756 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2008-12-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
166488-1 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 118AE1 | 05 |
| Street Address |
801 CO OP CITY BLVD |
| City | BRONX |
| State | NY |
| Zip Code | 10475-1603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467449355 | Hebrew Hospital Home, Inc. | Skilled Nursing Facility | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2005-10-05 |
| 1417585696 | Mst Khaleda Khatun | Internal Medicine | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2020-04-01 |
| 1699318675 | Woodmere Dialysis,llc | Clinic/Center | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2019-10-23 |
| 1518443415 | Ayesha Riaz | Internal Medicine | 801 Co Op City Blvd, Bronx, NY 10475 | 2018-07-13 |
| 1063914208 | John Bruce | Occupational Therapist | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2018-03-04 |
| 1942548250 | Carerite LLC | Technician/Technologist | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2013-01-21 |
| 1568720035 | Baypark Adc | Clinic/Center | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2012-05-02 |
| 1538352182 | Bay Park Center for Nursing and Rehabilitation, LLC | Skilled Nursing Facility | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2007-08-27 |
| 1942297783 | Hebrew Hospital Home, Inc. - Adult Day Care Bronx | Clinic/Center | 801 Co Op City Blvd, Bronx, NY 10475-1603 | 2005-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154973048 | Sharon Antoinette Hall | Registered Nurse | 2552 Pelham Bay Park West, Apt 1 D, 2551 Pelham Bay Park West, Bronx, NY 10475 | 2019-07-11 |
| 1265912042 | Bartow Pharmacy Inc. | Pharmacy | 500-5 Baychester Ave. Store #5, Bronx, NY 10475 | 2018-08-21 |
| 1518465996 | Jacqueline Caraballo | Nurse Practitioner | 100 De Kruif Place Apt 27h, Bronx, NY 10475 | 2018-01-31 |
| 1093227142 | Rachel Obeng Mireku | Licensed Practical Nurse | 140 Dekruif Place, Apt # 26k, Bronx, NY 10475 | 2017-10-30 |
| 1023534518 | Nelson Merritt Hall | Chiropractor | 2100 Bartow Ave, Ste #227, Bronx, NY 10475 | 2017-08-17 |
| 1245769363 | Sharon Holland Johnson | Licensed Practical Nurse | 140 Dekruif Pl, Bronx, NY 10475 | 2017-06-12 |
| 1740719152 | Nadia S Etienne | Licensed Practical Nurse | 120 De Kruif Place, Apt 18h, Bronx, NY 10475 | 2017-06-08 |
| 1407385891 | Ashley N Freeze | Case Manager/Care Coordinator | 140 Darrow Place Suite 24e, Bronx, NY 10475 | 2017-06-08 |
| 1912454091 | Usth.inc | Early Intervention Provider Agency | 120 Coop City Blvd, 21-f, Bronx, NY 10475 | 2016-09-06 |
| 1447626130 | Zelda Boomer | Registered Nurse | 920 Coop City Blvd Bx. Ny 10475, Bronx, NY 10475 | 2015-08-17 |
| Find all providers in zip 10475 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245462621 | Sharad Kothari | Internal Medicine | 3979 Laconia Ave, Bronx, NY 10466-4916 | 2009-08-18 |
| 1124288170 | Alina Gory | Internal Medicine | 664 Thwaites Pl Apt 2a, Bronx, NY 10467-7925 | 2008-06-12 |
| 1962684373 | Alejandra Villalobos | Internal Medicine | 1 Fordham Plz Ste 1000, Bronx, NY 10458-5871 | 2007-11-28 |
| 1497955041 | Bernard Stern | Internal Medicine | 3128 Palisade Ave, Bronx, NY 10463-1014 | 2007-07-23 |
| 1518019124 | Carole Michelsen | Internal Medicine | 66 Van Cortlandt Park South, St. Patricks Home, Bronx, NY 10463 | 2007-01-17 |
| 1356429740 | Riverdale Internal Medicine & Geriatric Services, PC | Internal Medicine | 5601 Riverdale Ave, Suite 1d, Bronx, NY 10471-2119 | 2006-11-01 |
| 1598851628 | Anna Skokowska-lebelt | Internal Medicine | 4141 Carpenter Ave, Renal Unit, Bronx, NY 10466-2600 | 2006-10-05 |
| 1932206752 | Hannah I Lipman | Internal Medicine | Mmc - Dept of Internal Med, 111 East 210th Street, Bronx, NY 10467 | 2006-09-20 |
| 1306888086 | Jomarie Zeleznik | Internal Medicine | 3224 Grand Concourse, #ba, Bronx, NY 10458-1008 | 2006-06-10 |
| 1083667935 | Srinivasa Reddy Adapa | Internal Medicine | 3950 White Plains Rd, Bronx, NY 10466-3026 | 2006-05-19 |
| Find all providers in BRONX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.