| NPI | 1841073863 |
|---|---|
| Former Name | MALLORY MASIELLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 030868) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-08-15 |
| Last Update Date | 2025-12-10 |