Mallory Fossa, PNP-PC
NPI 1780059030 · Pediatric Anesthesiology Physician · Hartford, CT
Provider details
- NPI number
- 1780059030
- Entity type
- Individual
- Primary specialty
- Pediatric Anesthesiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- PNP-PC
- Sex
- Female
- Sole proprietor
- Yes
- License
- 95003548 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 4650 W Sunset BlvdMs #12; 4th Floor Mcallister BuildingLos Angeles, CA 90027-6062Phone: (323) 361-7686
Registry dates
- Enumerated
- 2015-12-10
- Last updated
- 2022-09-12
- Certified
- 2022-09-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.