DR. PAUL F. MALLOY PHD
Clinical Neuropsychologist
Providence, Rhode Island
Provider NPI: 1144313909
Provider Information:DR. PAUL F. MALLOY PHD
Gender: M
Not Sole Proprietor
Practice Location:
345 BLACKSTONE BLVD PROVIDENCE, RI 02906 US
Tel: 401-455-6355 Fax: 401-455-6309
Business Mailing Address:
345 BLACKSTONE BLVD PROVIDENCE, RI 02906 US
Tel: 401-455-6355 Fax: 401-455-6293
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
X | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | RI | PS00261 |
X | 103T00000X | Behavioral Health & Social Service Providers Psychologist | RI | PS00261 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
BLUE CROSS | 25635-7 | RI | 01 |
UBH | 61-11141 | RI | 01 |
BLUE CHIP | 406667 | RI | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin