Mohammad Mallick, MD, LLC

Primary specialty

Psychiatric Hospital UnitTaxonomy code 273R00000X

License

22719 Issued in WI

Legal business name

MOHAMMAD MALLICK, MD, LLC

Practice address

1525 Liberty CT
Brookfield, WI 53045-5327

Phone

(262) 821-5525

Fax

(262) 821-5525

NPI assigned

Oct 23, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Mohammad Sultan Mallick, M.D.

Title

President

Phone

(282) 821-5525

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Mohammad Mallick MD LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Mohammad S Mallick MD LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brookfield, WI
  • NPI 1407048481
  NPD tax ID

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

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224720000000",
    "number": "1629221502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 LIBERTY CT",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455327",
            "telephone_number": "262-821-5525",
            "fax_number": "262-821-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 LIBERTY CT",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455327",
            "telephone_number": "262-821-5525",
            "fax_number": "262-821-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAMMAD MALLICK, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-23",
        "last_updated": "2008-10-23",
        "status": "A",
        "authorized_official_last_name": "MALLICK",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "SULTAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "282-821-5525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "WI",
            "license": "22719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31466300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mislinski-Zosel S.C.
• Mobile Audiology Associates, P.C.
• Mobile Dental Centers of Wisconsin Inc
• Rhoda Moeller, MSW
• Neal Ethan Moglowsky, M.S., L.P.C.
• Mohammad S Mallick MD LLC
• Katherine O Molling, PT
• Sandra Christie Moloney, P.T.
• Amirah Moore
• Grace Moore

• Psychiatric Hospital Unit in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Psychiatric Hospital Unit in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; 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.