Individual provider · NPI-1

Jayati Mallick, M.D.

Pathology, Hematology · Galveston, TX

NPI number1215355474

StatusActive

Last updated in NPPESDec 22, 2023

Details

NPI: 1215355474
Entity type: Individual (NPI-1)
Name: Jayati Mallick
Credential: M.D.
Sex: Female
Sole proprietor: Yes
Enumeration date: Apr 3, 2014
Certification date: Dec 22, 2023
Last updated: Dec 22, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207ZH0000X	Pathology, Hematology	S5008	TX	Yes
207ZP0102X	Pathology, Anatomic Pathology & Clinical Pathology	S5008	TX

Practice location

301 University Blvd
Galveston, TX 77555-0001

Phone 409-772-2222

Mailing address

Po Box 650859 Dept 710
Dallas, TX 75265-6234

Phone 409-772-0620

Other practice locations

Baystate Medical Ctr
759 Chestnut Street
Springfield, MA 01199-0001

Phone 413-794-0000

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