997 IONIA AVE, STATEN ISLAND, 10309, NEW YORK
| Entity Name | IMTIAZ A. MALLICK, M.D., P.C. |
| Entity Number | 1860303 |
| Status | ACTIVE |
| Incorporation Date | 17th October 1994 |
| Dos Process Address | 798 RTE 9, FISHKILL, 12524, NEW YORK |
| Jurisdiction | NEW YORK |
| County | DUTCHESS |
| Legal form | DOMESTIC PROFESSIONAL CORPORATION |