Provider Demographics
NPI:1538329412
Name:MALLIK, AMARA (DO)
Entity Type:Individual
Prefix:DR
First Name:AMARA
Middle Name:
Last Name:MALLIK
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Gender:F
Credentials:DO
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Mailing Address - Street 1:1410 PELHAM PKWY S
Mailing Address - Street 2:CERC @ ROSE F. KENNEDY CENTER (AECOM)
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1116
Mailing Address - Country:US
Mailing Address - Phone:718-430-8600
Mailing Address - Fax:718-892-2296
Practice Address - Street 1:1410 PELHAM PKWY S
Practice Address - Street 2:CERC @ ROSE F. KENNEDY CENTER (AECOM)
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1116
Practice Address - Country:US
Practice Address - Phone:718-430-8600
Practice Address - Fax:718-892-2296
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
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Provider Licenses
StateLicense IDTaxonomies
NY2414132080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics