Provider Demographics
NPI:1790432706
Name:MALLOY, SAMONIA ELIZABETH II
Entity Type:Individual
Prefix:
First Name:SAMONIA
Middle Name:ELIZABETH
Last Name:MALLOY
Suffix:II
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 CARPENTER AVE APT 3A
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-1610
Mailing Address - Country:US
Mailing Address - Phone:718-802-8166
Mailing Address - Fax:
Practice Address - Street 1:203 CARPENTER AVE APT 3A
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-1610
Practice Address - Country:US
Practice Address - Phone:718-802-8166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker