Mallouk, Abdelkader
Mallouk, Abdelkader is an individual health care provider with primary practice located at 100 John Roemmelt Dr Ste 302 , Horseheads NY 14845-8304. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Mallouk, Abdelkader can be contacted via phone (607) 873-1810.Contact Information
Primary practice address
100 John Roemmelt Dr Ste 302
Horseheads NY 14845-8304
Phone: (607) 873-1810
Fax: (607) 562-3157
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPC3141 | Florida |
| Eye and Vision Services Providers / Optometrist | 152W00000X | T005983 | New York |
| Eye and Vision Services Providers / Optometrist | 152W00000X | OE8142 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X | 277295 | New York |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 277295 | New York |
Profile Details
| NPI number | 1407949621 |
|---|---|
| LBN Legal business name | Mallouk, Abdelkader |
| Credentials | MD, OD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Apr 11th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407949621 | NPPES |
| New York | MEDICAID | 01916898 |
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