Mallory Telese, PHARMD

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

CI064217 Issued in NY

Practice address

100 Technology Center Dr
Stoughton, MA 02072-4710

Phone

(781) 566-5066

NPI assigned

Feb 9, 2021

Last updated

Aug 30, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mallory Kuchis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1407448616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MERION AVE",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120651119",
            "telephone_number": "518-225-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TECHNOLOGY CENTER DR",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020724710",
            "telephone_number": "781-566-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELESE",
        "first_name": "MALLORY",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "NY",
            "license": "CI064217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "KUCHIS",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Ambulatory Care Pharmacist in Stoughton, MA
• Providers in Stoughton, MA by specialty
• Ambulatory Care Pharmacist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.