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Provider Information for 1083715825

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. RICHARD MALLEY MD

Gender: MALE

Individual NPI: 1083715825

Calendar   Last Updated:  2008-10-09
  Certification Date: 

Details

Name Value
NPI 1083715825
Enumeration Date 2006-09-26
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE CHILDREN'S HOSPITAL ENDERS 861.3
BOSTON, MA 02115-5724
United States

Phone: 617-919-2900 | Fax:
View Map External Link
Primary Practice Address 300 LONGWOOD AVE CHILDREN'S HOSPITAL ENDERS 861.3
BOSTON, MA 02115-5724
United States

Phone: 617-919-2900 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID MA 3135800
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 2080P0208X - Pediatrics Pediatric Infectious Diseases MA 77989