| Bhoosa Malliah, Md. Pa | |
|
222 Jack Martin Blvd Suite. E, Bricktown NJ 08724-7772 | |
| (732) 840-8688 | |
| (732) 840-8480 |
| Full Name | Bhoosa Malliah, Md. Pa |
|---|---|
| Speciality | Internal Medicine - Adolescent Medicine |
| Location | 222 Jack Martin Blvd, Bricktown, New Jersey |
| Authorized Official Name and Position | Bhoosa Malliah (PHYSICIAN) |
| Authorized Official Contact | 7328408688 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bhoosa Malliah, Md. Pa 222 Jack Martin Blvd Suite. E, Bricktown NJ 08724-7772 Ph: (732) 840-8688 | Bhoosa Malliah, Md. Pa 222 Jack Martin Blvd Suite. E, Bricktown NJ 08724-7772 Ph: (732) 840-8688 |
| NPI Number | 1639145436 |
|---|---|
| Provider Enumeration Date | 02/23/2006 |
| Last Update Date | 09/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639145436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RA0000X | Internal Medicine - Adolescent Medicine | (* (Not Available)) | Primary |