Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mallard Professional Services Inc

Organization Emergency Medicine Physician · NPI 1699455519

Mallard Professional Services Inc is an Emergency Medicine Physician in Massapequa, New York. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5550 Merrick Rd
Massapequa, NY 11758-6238
Phone: (516) 814-2900
Fax: (631) 673-1314
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Emergency Medicine Physician Taxonomy 207P00000X
Internal Medicine Physician Taxonomy 207R00000X

Record details

NPI number1699455519
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donna Scoca — Credentialing · (631) 673-3233
NPI enumeratedJuly 25, 2023
Last updated in NPPESAugust 2, 2023
Certification dateAugust 2, 2023
Mailing address5550 Merrick Rd, Massapequa, NY 11758-6238

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