Mallick Qaiser Alam, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

034112 Issued in CT

Practice address

77 Grand Ave
New Haven, CT 06513-3906

Phone

(203) 562-8697

Fax

(203) 562-1822

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New Haven Walk in Medical Center

  • Pediatrics Physician
  • New Haven, CT
  • NPI 1285837401

  CT

  Medicare reassignment NPD Authorized official

Specialty

Family Practice

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

• Qaiser Mallick Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467529271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133906",
            "telephone_number": "203-562-8697",
            "fax_number": "203-562-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133906",
            "telephone_number": "203-562-8697",
            "fax_number": "203-562-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAM",
        "first_name": "MALLICK",
        "middle_name": "QAISER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CT",
            "license": "034112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "QAISER",
            "last_name": "MALLICK",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Yaser M Tariq Al-Jobory
• Adel Abdulrahman Al-Marshad, MD
• Abeer Abdulaziz Al-Raddadi, MD
• Mohammed Al-Salihi, MD
• Arifa Khanam Alam
• Parisha Alam
• Syed Muneeb Alam, MD
• Alan H. Lovins PH D P C
• Alan P. Friedler, D.M.D., P.C.
• Omar Alani, MD

• All providers in New Haven, CT
• General Practice Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.