WILLIAM KINNEY MALLON JR. (NPI# 1881635811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881635811 |
| Entity Type | Individual |
| Full Name | WILLIAM KINNEY MALLON JR. |
| Credential | MD |
| Practice Address |
Stony Brook Medicine Dept of Emergency Hsc, Level 4, Room 080 Stony Brook NY 11794-8350 |
| Mailing Address |
Po Box 1554 Stony Brook NY 11790-0988 |
| Practice Telephone | 6314442478 |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2015-11-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
282233 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G640550 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013090885 | William Gunther Mallon | Nurse Anesthetist, Certified Registered | 2149 Found Lake Rd. Box 625, Saint Germain, WI 54558-0625 | 2006-10-23 |
| 1558737916 | William Mallon IIi | Counselor | 780 American Legion Hwy, Roslindale, MA 02131-3908 | 2015-08-19 |
| 1578982716 | William Mallon | Student in an Organized Health Care Education/Training Program | 111 E 210th St, Montefiore Medical Center - Dept of Radiology, Bronx, NY 10467-2401 | 2014-04-15 |
| 1114976479 | William J. Mallon | Ophthalmology | 3500 Us Highway 1, Vero Beach, FL 32960-4511 | 2006-05-06 |
| 1366437048 | William James Mallon | Orthopaedic Surgery | 120 William Penn Plz, Durham, NC 27704-2150 | 2005-09-19 |
| Street Address |
STONY BROOK MEDICINE DEPT OF EMERGENCY HSC, LEVEL 4, ROOM 080 |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11794-8350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588035729 | Jacqueline Greger | Physician Assistant | Stony Brook Medicine Dept of Emergency, Hsc, Level 4, Room 080, Stony Brook, NY 11794-8350 | 2015-10-14 |
| 1811126642 | Ayse Meltem Avcioglu | Emergency Medicine | Stony Brook Medicine Dept of Emergency, Hsc, Level 4, Room 080, Stony Brook, NY 11794-8350 | 2009-07-14 |
| 1174787154 | Liza Leung | Emergency Medicine | Stony Brook Medicine Dept of Emergency, Hsc, Level 4, Room 080, Stony Brook, NY 11794-8350 | 2008-07-18 |
| 1255509311 | Rory Jess Spiegel | Emergency Medicine | Stony Brook Medicine Dept of Emergency, Hsc, Level 4, Room 080, Stony Brook, NY 11794-8350 | 2008-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619506714 | Ryan John Kottmeier | Physician Assistant | 101 Nicolls Road Suny Stony Brook Hospital, Dept of Orthopedics Hsc T18, Room 080, Stony Brook, NY 11794 | 2020-04-02 |
| 1699302109 | Michael Trentalange | Student in an Organized Health Care Education/Training Program | Department of Surgery, Health Sciences Center Level 19, Room 030, Stony Brook, NY 11794 | 2020-03-25 |
| 1164985156 | Lauren Kate Harris | Student in an Organized Health Care Education/Training Program | Stony Brook Medicine, Department of Ob/gyn, Hsc T9, 101 Nicolls Road, Stony Brook, NY 11794 | 2019-04-08 |
| 1851851448 | Kathy Tin | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc 16 Suny Stony Brook Hospital, Stony Brook, NY 11794 | 2019-03-21 |
| 1174083703 | Arham Khan | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc Level 16, Suny Stony Brook Hosp, Stony Brook, NY 11794 | 2019-03-20 |
| 1396221982 | Aman Bhojani | Student in an Organized Health Care Education/Training Program | Suny At Stony Brook Dental School, South Drive, Stony Brook, NY 11794 | 2018-07-17 |
| 1699265629 | Belliny Phaeton | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Hospital, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-15 |
| 1629568969 | Rachel Herold | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Department of Pediatrics, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-11 |
| 1598254419 | Nora Ann Diraimondo | Nurse Practitioner | Sb Hospital 101 Nicolls Road, Department of Medicine, Stony Brook, NY 11794 | 2018-05-07 |
| 1386140705 | Ryan Christopher Corn | Student in an Organized Health Care Education/Training Program | Dept. of Internal Medicine, Hsc Level 16-020, Suny Stony Brook, Stony Brook, NY 11794 | 2018-04-04 |
| Find all providers in zip 11794 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467472498 | Christopher Edelstein | Emergency Medicine | 100 Nicolls Rd, Stony Brook, NY 11790-3407 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588129852 | Steve Lazo | Emergency Medicine | 3210 Greenpoint Ave, Long Island City, NY 11101-2010 | 2019-01-31 |
| 1730667734 | Lagrange Fire District | Emergency Medicine | 504 Freedom Plains Road, Poughkeepsie, NY 12603-2678 | 2018-08-01 |
| 1407217631 | Debonotropepamdpc | Emergency Medicine | 24 Charter Ave, Dix Hills, NY 11746-6447 | 2016-03-16 |
| 1699013946 | Medfirst Urgent Care | Emergency Medicine | 1751 Sheridan Dr, Tonawanda, NY 14223 | 2013-01-22 |
| 1356689855 | Medfirst Urgent Care, Pllc | Emergency Medicine | 3190 Niagara Falls Blvd, Amherst, NY 14228-1639 | 2013-01-18 |
| 1821341744 | Stat Medical Usa | Emergency Medicine | 1943 Vincent Ln, Syosset, NY 11791-9629 | 2012-10-16 |
| 1104132190 | Kildare Clarke | Emergency Medicine | 6 Hazelton Dr, White Plains, NY 10605-3805 | 2010-08-27 |
| 1659682219 | Mark Kenneth Ellis | Emergency Medicine | 2 5th Ave Apt 2d, New York, NY 10011-8832 | 2010-06-29 |
| 1497076806 | Jose Luis Romero | Emergency Medicine | 3636 Waldo Ave Apt 4n, Bronx, NY 10463-2256 | 2010-06-21 |
| 1619109121 | Matthew J. Krauthamer | Emergency Medicine | 16 Capri Ct, Dix Hills, NY 11746-6410 | 2009-08-17 |
| Find all providers with the same taxonomy | ||||
| City | STONY BROOK |
| Zip Code | 11794 |
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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.