Mallenbaum, Sidney

Mallenbaum, Sidney is an individual health care provider with primary practice located at 3 Riverside Cir , Roanoke VA 24016-4955. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Mallenbaum, Sidney can be contacted via phone (540) 224-5170.

Contact Information

Primary practice address
3 Riverside Cir Roanoke VA 24016-4955
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X ME137451 Florida
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 0101045430 Virginia

Profile Details

NPI number 1588734172
LBN Legal business name Mallenbaum, Sidney
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2006
Last updated Dec 9th, 2020 - about 5 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 1588734172 NPPES
Florida MEDICAID 1011645-00

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