Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 25MB09991700 | NJ |
NPI | 1023436433 |
---|---|
Provider Name | Dr. Ankit Malik |
First Address | Matawan, NJ 07747-6834 |
Second Address | Somers Point, NJ 08244-2340 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 06/12/2017 |