Athanasios Mallios, M.D., P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

120555 Issued in NY

Legal business name

ATHANASIOS MALLIOS, M.D., P.C.

Practice address

15 W 72ND St
Suite 1T
New York, NY 10023-3402

Phone

(212) 787-0091

Fax

(212) 721-1636

NPI assigned

Mar 24, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Athanasios Mallios, M.D.

Title

Owner

Phone

(212) 787-0091

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300924800000",
    "number": "1104125541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W 72ND ST",
            "address_2": "SUITE 1T",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100233402",
            "telephone_number": "212-787-0091",
            "fax_number": "212-721-1636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W 72ND ST",
            "address_2": "SUITE 1T",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100233402",
            "telephone_number": "212-787-0091",
            "fax_number": "212-721-1636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHANASIOS MALLIOS, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-24",
        "last_updated": "2011-03-24",
        "status": "A",
        "authorized_official_last_name": "MALLIOS",
        "authorized_official_first_name": "ATHANASIOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-787-0091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "120555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00305037",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.