Provider Demographics
NPI:1740381680
Name:MULLICA HILL MEDICAL ASSOCIATES PC
Entity type:Organization
Organization Name:MULLICA HILL MEDICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:POOJA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-478-2111
Mailing Address - Street 1:201 BRIDGETON PIKE
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-2671
Mailing Address - Country:US
Mailing Address - Phone:856-478-2111
Mailing Address - Fax:856-478-4709
Practice Address - Street 1:201 BRIDGETON PIKE
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-2671
Practice Address - Country:US
Practice Address - Phone:856-478-2111
Practice Address - Fax:856-478-4709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2009-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
106669Medicare PIN
106670Medicare PIN