Eng Burger, Mallory

Eng Burger, Mallory is an individual health care provider with primary practice located at 728 N Main St , New Square NY 10977-8916. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Eng Burger, Mallory can be contacted via phone (845) 354-9033.

Contact Information

Primary practice address
728 N Main St New Square NY 10977-8916
Phone: (845) 354-9033
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X R195051 Maryland
Nursing Service Providers / Registered Nurse 163W00000X R195051 Maryland
Nursing Service Providers / Registered Nurse 163W00000X 617014 New York
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 382293 New York

Profile Details

NPI number 1104116763
LBN Legal business name Eng Burger, Mallory
Credentials MS, CPNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2011
Last updated Oct 12th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104116763 NPPES
Maryland MEDICAID 119591300

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