Mary Mallavarapu MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

121643 Issued in NY

Legal business name

MARY MALLAVARAPU MD

Practice address

100 Phillips Hill Rd
New City, NY 10956-4134

Phone

(845) 634-0068

NPI assigned

May 11, 2009

Organization subpart

Yes

Parent organization

MARY MALLAVARAPU MDAs reported in NPPES

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

Authorized official

Name

Ms. Anita Soares, MBA

Title

Office Manager

Phone

(845) 634-0068

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Mary T Mallavarapu2 organizations share this tax ID, including this one

Part of

Mary T Mallavarapu

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mary Mallavarapu MD

  • Pediatrics Physician
  • Pomona, NY
  • NPI 1669606547
  NPD tax ID

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242000000000",
    "number": "1124252705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 ROUTE 45",
            "address_2": "SUITE 112",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703500",
            "telephone_number": "845-354-8054",
            "fax_number": "845-354-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PHILLIPS HILL RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109564134",
            "telephone_number": "845-634-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY MALLAVARAPU MD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARY MALLAVARAPU MD",
        "enumeration_date": "2009-05-11",
        "last_updated": "2009-05-11",
        "status": "A",
        "authorized_official_last_name": "SOARES",
        "authorized_official_first_name": "ANITA",
        "authorized_official_title_or_position": "OFFICE  MANAGER",
        "authorized_official_telephone_number": "845-634-0068",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "121643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00515435",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerald P Marinoff, MD
• Mario F Pellegrino Peds OT PC
• Marriage and Mental Health Counseling, PC
• Robert Marrone, DDS
• Louis Martorella, MD
• Joseph Maselli, MD
• Charles Mastro, BCBA
• Anna Mathew
• Anna Mathew, M.D.
• Asha Kochumon Mathew

• Pediatrics Physician in New City, NY
• Providers in New City, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; 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.