Shahla Mallick Medical PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

217612 Issued in NY

Legal business name

SHAHLA MALLICK MEDICAL PC

Practice address

517 54TH St
Brooklyn, NY 11220-3114

Phone

(718) 833-7860

Fax

(718) 833-7861

NPI assigned

Feb 4, 2011

Organization subpart

No

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

Authorized official

Name

Shahla MallickNPI 1861506818

Title

Doctor

Phone

(718) 833-7860

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shahla Sohaib Mallick

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1861506818
  NPD Authorized official

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

{
    "created_epoch": "1296777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1245536440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 PARKWAY DR",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772737",
            "telephone_number": "718-833-7860",
            "fax_number": "718-833-7861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 54TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203114",
            "telephone_number": "718-833-7860",
            "fax_number": "718-833-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHLA MALLICK MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "MALLICK",
        "authorized_official_first_name": "SHAHLA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "718-833-7860"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "217612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02106307",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naji Abi Shahin, MD
• Pooria Shahin
• Ayman A Shahine, M.D.
• Afshin Shahkoohi, MD
• Shahram Shahkoohi
• Tatyana Shahova
• Veer Singh Shahpuri, M.D.
• Shahram Shekib, DDS, Fagd, PC
• Ulviyya N/a Shahverdiyeva
• Ali Shahzad, MD

• Primary Care Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.