Michelle P. Mallitz, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

042937 Issued in CT

Practice address

5520 Park Ave
101
Trumbull, CT 06611-3463

Phone

(203) 371-5873

Fax

(203) 371-5874

NPI assigned

Aug 13, 2006

Last updated

May 31, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1386656825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 PARK AVE",
            "address_2": "101",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066113463",
            "telephone_number": "203-371-5873",
            "fax_number": "203-371-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 PARK AVE",
            "address_2": "101",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066113463",
            "telephone_number": "203-371-5873",
            "fax_number": "203-371-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLITZ",
        "first_name": "MICHELLE",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2013-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "042937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001429374",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Elizabeth Maier, M.ED., BCBA, LBA-CT
• John Leonard Maiocco, D.P.M.
• Sagar Makanji, PHARM D
• Jerry P Malefatto, MD
• Nasreen Bagwan Malik, M.D.
• June Gellis Malone, PH.D.
• Alaina Erini Mandrapilias, MD
• John V Mangieri, MD
• Marwa Mansour
• Amanda Manuel, LPC

• Internal Medicine Physician in Trumbull, CT
• Providers in Trumbull, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; 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.