Jannette Matos Malloy | New York, NY • PECOS Search

Jannette Matos Malloy

Pharmacist

Pharmacy Service Providers

617 W 181st St, New York, NY 10033-4937

PECOS Enrollment

Based on the most recent information from CMS, provider Jannette Matos Malloy does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 11 days ago.

Profile Details

Provider ID
1871721795
Provider Type
Individual
Full Name
Matos Malloy, Jannette
Title
Mrs.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
6/30/2009
Last Updated
6/30/2009

Contact Information

Practice Location

617 W 181st St, New York, NY 10033-4937

Unlisted Fax

Mailing Location

617 W 181st St, New York, NY 10033-4937

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 183500000X Primary	Description Pharmacist Pharmacy Service Providers	License 038661 New York