Mallaro Anesthesia LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

MALLARO ANESTHESIA LLC

Practice address

1615 Petroglyph Point Dr
Prescott, AZ 86301-6539

Phone

(325) 675-6466

Fax

(325) 692-6030

NPI assigned

Sep 20, 2023

Organization subpart

No

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

Authorized official

Name

Poppy Walker, MBA

Title

Practice Administrator

Phone

(325) 675-6466

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1104604198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 S 14TH ST STE 16180",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796055015",
            "telephone_number": "325-675-6466",
            "fax_number": "325-692-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 PETROGLYPH POINT DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863016539",
            "telephone_number": "325-675-6466",
            "fax_number": "325-692-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLARO ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "POPPY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "325-675-6466",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Joseph Maiorana, DPT
• Mauricio Mairena, LCSW
• Ana Christina Malachowski, L.M.T, M.M.P,
• Paul M Malczak, DO
• Thad Malik
• Victoria Marie Maneely, CPHT
• Stefanie Maneval, RN
• Karie Mangiardi-Hammond, OTR/L
• Joseph Brett Mangum, DDS
• Richard Turner Mangum, D.D.S.

• Certified Registered Nurse Anesthetist in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Certified Registered Nurse Anesthetist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.