THERESA MALLORY NP NPI 1568431161

NPI Information

NPI: 1568431161
Provider Name: THERESA MALLORY, NP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Address:
10 WILLARD STREET
QUINCY, MA
ZIP 02169
Phone: (617) 479-1437
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Theresa Mallory, NP is an adult health nurse practitioner in Quincy, MA. Theresa Mallory, NP NPI is 1568431161. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

10 WILLARD STREET
QUINCY, MA
ZIP 02169
Phone: (617) 479-1437
Fax: (617) 479-3500

The enumeration date for this NPI number is 3/16/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	128754	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	N318	OTHER	MASSACHUSETTS	HPHC
2	357472	MEDICAID	MASSACHUSETTS
3	NP2083	OTHER	MASSACHUSETTS	BC/BS
4	S94177	MEDICARE UPIN	MASSACHUSETTS
5	NP2083	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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