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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MALLORY FOSSA, PNP-PC

Active Sole Proprietor

MALLORY FOSSA, PNP-PC is a Pain Medicine healthcare provider located in HARTFORD, Connecticut. NPI 1780059030 is currently active in the NPPES registry. Verify at CMS.

Pain Medicine · HARTFORD, CT

Registration Details

NPI Number
1780059030
Provider Type
Individual
Gender
Female
NPI Issued
Dec 10, 2015 (10.695742429039 yrs)
Last Updated
Sep 12, 2022
Licenses
95003548 (CA)
12.008276 (CT)
95003548 (CA)
Sole Proprietor
Yes

Practice Information

Address
282 WASHINGTON ST
HARTFORD, CT, 061063322
Browse CT providers · Browse ZIP 06106
Phone
8608375207
Primary Specialty
Pain Medicine
207LP3000X
Additional Specialty
Pediatric Nurse Practitioner
Additional Specialty
Pain Medicine

Other Pain Medicine Providers in HARTFORD, CT

Name Credential NPI
KAPAUNER R LEWIS M.D. 1619934577
CHERYL BLINE M.D. 1790006344
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.