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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:

PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
RIPS00261
X103T00000XBehavioral Health & Social Service Providers
Psychologist
RIPS00261

Other Provider Identifiers:

IssuerNumberStateType
BLUE CROSS25635-7RI01
UBH61-11141RI01
BLUE CHIP406667RI01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS RI - Page 1



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