TILAK KUMAR MALLIK (NPI# 1437160959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437160959 |
| Entity Type | Individual |
| Full Name | TILAK KUMAR MALLIK |
| Credential | MD |
| Practice Address |
1111 Medical Center Blvd Suite S 113 Marrero LA 70072-3151 |
| Mailing Address |
1111 Medical Center Blvd Suite S113 Marrero LA 70072-3151 |
| Practice Telephone | 5043496520 |
| Practice Fax Number | 5043496522 |
| Mailing Telephone | 5043496520 |
| Mailing Fax Number | 5043496522 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2018-03-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
04776R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1317926 | 05 |
| Street Address |
1111 MEDICAL CENTER BLVD SUITE S 113 |
| City | MARRERO |
| State | LA |
| Zip Code | 70072-3151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487657359 | West Jefferson Surgery Center, LLC | Clinic/Center | 1111 Medical Center Blvd, Ste 105n, Marrero, LA 70072-3152 | 2005-05-24 |
| 1972129211 | Marissa Liantonio Miller | Nurse Practitioner | 1111 Medical Center Blvd, Marrero, LA 70072-3151 | 2020-06-23 |
| 1952920324 | Kirstie Rae Schieffler | Physician Assistant | 1111 Medical Center Blvd, Marrero, LA 70072-3151 | 2020-04-15 |
| 1841730918 | Samantha Schenker | Nurse Practitioner | 1111 Medical Center Blvd, N406, Marrero, LA 70072-3151 | 2017-03-08 |
| 1376092379 | Shelli Rodriguez Ergen | Nurse Practitioner | 1111 Medical Center Blvd, Suite South 113, Marrero, LA 70072-3151 | 2016-10-02 |
| 1326418443 | Cain Foot Center, LLC | Podiatrist | 1111 Medical Center Blvd, Suite N-313, Marrero, LA 70072-3151 | 2015-10-01 |
| 1235515693 | Joseph Guarnieri | Eyewear Supplier (Equipment, not the service) | 1111 Medical Center Blvd, Suite N-114, Marrero, LA 70072-3151 | 2015-08-07 |
| 1639552979 | Kelly Thibodeaux | Nurse Practitioner | 1111 Medical Center Blvd, 350s, Marrero, LA 70072-3151 | 2015-07-06 |
| 1629478409 | Ochsner Clinic LLC | General Practice | 1111 Medical Center Blvd, Suite 313n, Marrero, LA 70072-3151 | 2014-08-28 |
| 1285034553 | Raven S Jackson | Pharmacist | 1111 Medical Center Blvd, S 850, Marrero, LA 70072-3151 | 2014-08-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780232579 | Brittany Inez Young | Technician | 4465 Bay View Drive, Marrero, LA 70072 | 2019-08-27 |
| 1356829774 | Zachary Allen Runge Kleinpeter | Physician Assistant | 1111 Medical Center Blvd Ste S630, Marrero, LA 70072 | 2018-07-30 |
| 1689172611 | Derron White | Specialist | 2324 Barataria Blvd, Marrero, LA 70072 | 2018-01-24 |
| 1477064616 | Bone & Joint, LLC Physical Therapy | Physical Therapist | 4633 Wichers Dr., Marrero, LA 70072 | 2017-10-16 |
| 1477077410 | Darlene Jenkins | Case Manager/Care Coordinator | 7606 Westbank Expy Ste B, Marrero, LA 70072 | 2017-08-01 |
| 1871017186 | Tyra K Haynes | Non-emergency Medical Transport (VAN) | 536 Westwood Drive, Marrero, LA 70072 | 2017-07-28 |
| 1265961536 | Danika Kayelle Frank | Social Worker | 6189 Boutte St, Marrero, LA 70072 | 2017-06-08 |
| 1528596673 | Monica Cheree Mayberry | Counselor | 931 Westwood Dr., Marrero, LA 70072 | 2017-06-01 |
| 1710419197 | Sharla Black | Counselor | 2069 Paine Drive, Marrero, LA 70072 | 2017-04-03 |
| 1699207043 | Tango Austin | Counselor | 2573 Foliage Drive, Marrero, LA 70072 | 2017-04-03 |
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| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306258884 | Alejandra Virginia Riera Gonzalez | Internal Medicine | 1111 Medical Center Blvd Ste S850, Marrero, LA 70072-3173 | 2014-06-02 |
| 1205027349 | Marideli Colon Scanlan | Internal Medicine | 1111 Medical Center Blvd N713, Marrero, LA 70072 | 2007-08-05 |
| 1568508976 | Tilak K Mallik Md Face LLC | Internal Medicine | 1111 Medical Center Blvd, Suite S113, Marrero, LA 70072 | 2007-01-30 |
| 1649373630 | Sadda R Reddy | Internal Medicine | 4225 Lapalco Blvd, Marrero, LA 70072 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316413560 | Southern Endocrinology LLC | Internal Medicine | 102 Thomas Rd Ste 113, West Monroe, LA 71291-7365 | 2018-10-15 |
| 1689913832 | Sylvia Ann Heidingsfelder | Internal Medicine | 5805 Highland Rd, Baton Rouge, LA 70808-6559 | 2013-02-07 |
| 1649562604 | Dragana Lovre | Internal Medicine | 1430 Tulane Ave # 8553, New Orleans, LA 70112-2632 | 2011-05-10 |
| 1902123995 | Abdul Mannan Khan | Internal Medicine | 15813 Paul Vega Md Dr Ste 300a, Hammond, LA 70403-1431 | 2010-04-29 |
| 1598928749 | Edward L. Michals | Internal Medicine | 2639 Desoto St, New Orleans, LA 70119-3008 | 2008-07-08 |
| 1295994432 | Karen E. Friday | Internal Medicine | 1012 Philip St, New Orleans, LA 70130-5552 | 2008-06-03 |
| 1548306137 | Lydia Yvonne Melendez Ramirez | Internal Medicine | 1400 Poydras St, Ambulatory Dept 3rd Floor, New Orleans, LA 70112-5100 | 2007-01-30 |
| 1215009360 | Mark Christian Lueg | Internal Medicine | 300 Mariners Plaza, Suite 303, Manderville, LA 70448 | 2006-11-14 |
| 1255448973 | Iberia General Hospital and Medical Center | Internal Medicine | 2205 Old Jeanerette Rd, New Iberia, LA 70563-8687 | 2006-08-25 |
| 1962436097 | Gay M Story | Internal Medicine | 5428 Odonovan Dr, Ste B, Baton Rouge, LA 70808-4374 | 2006-07-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.