National Provider Identifier

Abdelkader Mallouk, MD, OD

Abdelkader Mallouk, MD, OD is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Horseheads, NY and a listed phone number of (607) 873-1810.

NPI 1407949621Horseheads, NYFamily Medicine Physician

Profile Overview

NPI
1407949621
Provider Type
Individual
Primary Specialty
Family Medicine Physician
Enumeration Date
October 02, 2006
Last Updated
April 11, 2022

Practice Location

  • 100 John Roemmelt Dr Ste 302
  • Horseheads, NY 14845-8304

Phone: (607) 873-1810

Mailing Address

  • 571 Saint Josephs Blvd Fl 2
  • Elmira, NY 14901-3230

Specialties

  • Family Medicine Physician (207Q00000X)
  • Addiction Medicine (Family Medicine) Physician (207QA0401X)
  • Optometrist (152W00000X)
Full Record
NPI
1407949621
Entity Type
Individual
Last Name
Mallouk
First Name
Abdelkader
Name Prefix
Mr.
Credential
MD, OD
Mailing Street Address
571 Saint Josephs Blvd Fl 2
Mailing City
Elmira
Mailing State
NY
Mailing ZIP Code
14901-3230
Mailing Country
US
Mailing Phone
(607) 271-2050
Practice Street Address
100 John Roemmelt Dr Ste 302
Practice City
Horseheads
Practice State
NY
Practice ZIP Code
14845-8304
Practice Country
US
Practice Phone
(607) 873-1810
Practice Fax
(607) 562-3157
Enumeration Date
October 02, 2006
Last Updated
April 11, 2022
Sex
Male
Sole Proprietor
No
Certification Date
April 11, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Family Medicine Physician (207Q00000X), Addiction Medicine (Family Medicine) Physician (207QA0401X), Optometrist (152W00000X)
Other Identifiers
01916898 (NY)