Provider Demographics
NPI:1003533407
Name:MALYIL, ABY (BDS, MDS, DMD)
Entity Type:Individual
Prefix:DR
First Name:ABY
Middle Name:
Last Name:MALYIL
Suffix:
Gender:M
Credentials:BDS, MDS, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 COMMERCE DR APT 2108
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2928
Mailing Address - Country:US
Mailing Address - Phone:405-845-5225
Mailing Address - Fax:
Practice Address - Street 1:CHERRY HILL FAMILY DENTAL
Practice Address - Street 2:1617 KINGS HIGHWAY
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034
Practice Address - Country:US
Practice Address - Phone:856-857-0053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-26
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI029788001223G0001X
PADS0443161223G0001X
MD182811223G0001X
MADL154521223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
No1223G0001XDental ProvidersDentistGeneral Practice