Provider Demographics
NPI:1679911366
Name:MARKLOFF, MALLORY D (MD)
Entity Type:Individual
Prefix:
First Name:MALLORY
Middle Name:D
Last Name:MARKLOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 CHAMBERS HILL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-7304
Mailing Address - Country:US
Mailing Address - Phone:717-709-7922
Mailing Address - Fax:717-263-2055
Practice Address - Street 1:100 CHAMBERS HILL DR STE 200
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-7301
Practice Address - Country:US
Practice Address - Phone:717-709-7930
Practice Address - Fax:717-709-7931
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2557062084P0800X
PAMD4642242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry