Scott Mallon

NPI 1700164803 · on the registry since 2011

Practice

Address: 1688 Victory Blvd
Staten Island, NY 10314
Phone: (718) 815-4111
Organisation at this address: Bridge Back To Life, Inc.
Bridge Back To Life, Inc.
Bridge Back To Life Center, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 26

Registry record

Primary taxonomy: 106H00000X
106H00000X
Licence states on file: NY
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2011-07-25

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York