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Contact Information

JUAN J MALLARI, MD
1440 MAIN STREET
WALTHAM, MA02451
 Phone: 781-891-9300
 Fax: 781-891-9305
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for JUAN J MALLARI · (Male)

NPI # 1508834854
Status Active
Credentials MD
Entity Individual
Enumeration date 03/12/2006
Last updated 01/22/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 037082
  • MA License # 78874
  • NJ License # 25MA08043200
  • CT Medicaid 001370824
  • MA Medicaid 3175987
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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