Provider Demographics
NPI:1952505299
Name:MALAHOSKY, MARK JOSEPH (R PH)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:JOSEPH
Last Name:MALAHOSKY
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 SCIENCE PARKWAY
Mailing Address - Street 2:PHARMACY ADMINISTRATION
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4251
Mailing Address - Country:US
Mailing Address - Phone:585-210-4152
Mailing Address - Fax:877-616-3088
Practice Address - Street 1:259 MONROE AVE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-3632
Practice Address - Country:US
Practice Address - Phone:585-241-9000
Practice Address - Fax:585-454-2017
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036757183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist