| Doctor Name: | ASHITH MALLY |
| NPI Number: | 1609849157 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | MD-053003L |
| Business Practice Address: | 5000 Waterdam Plaza Dr Suite 120 Mc Murray, PA - 153175412 |
| Business Phone Number: | 7249418877 |
| Business Fax Number: | 7249414745 |
| Mailing Address: | 201 Redwood Dr, VENETIA |
| State: | PA |
| Postal Code: | 153671047 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/07/2006 |
| NPI Last Update Date: | 02/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | MD-053003L |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |