Provider Demographics
NPI:1871740647
Name:MALLIK, SHALINI GILOTRA (MD)
Entity type:Individual
Prefix:DR
First Name:SHALINI
Middle Name:GILOTRA
Last Name:MALLIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 CLEVELAND PLACE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-1024
Mailing Address - Country:US
Mailing Address - Phone:504-905-4771
Mailing Address - Fax:504-457-0046
Practice Address - Street 1:5220 CLEVELAND PL
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-1024
Practice Address - Country:US
Practice Address - Phone:504-905-4771
Practice Address - Fax:504-457-0046
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14465R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics