Malikkal, Tressa Mary
Malikkal, Tressa Mary is an individual health care provider with primary practice located at 115 W Main St Ste A , Trappe PA 19426-2068. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Malikkal, Tressa Mary can be contacted via phone (610) 831-8060.Contact Information
Primary practice address
115 W Main St Ste A
Trappe PA 19426-2068
Phone: (610) 831-8060
Fax: (610) 831-8061
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Vision Therapy | 152WV0400X | OEG-000634 | Pennsylvania |
| Eye and Vision Services Providers / Optometrist | 152W00000X | OEG-000634 | Pennsylvania |
Profile Details
| NPI number | 1902983208 |
|---|---|
| LBN Legal business name | Malikkal, Tressa Mary |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Feb 22nd, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902983208 | NPPES |
| Pennsylvania | MEDICAID | 1821546 |
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