Provider Demographics
NPI:1912795550
Name:MALLARKEY, DAVID JR (RN)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MALLARKEY
Suffix:JR
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-5716
Mailing Address - Country:US
Mailing Address - Phone:570-283-2161
Mailing Address - Fax:570-714-0670
Practice Address - Street 1:560 PIERCE ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5716
Practice Address - Country:US
Practice Address - Phone:570-283-2161
Practice Address - Fax:570-714-0670
Is Sole Proprietor?:No
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN722717163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management