1265431258 NPI number — SHAWN MALONEY P.T.

Table of content: SHAWN MALONEY P.T. (NPI 1265431258)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265431258 NPI number — SHAWN MALONEY P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MALONEY
Provider First Name:
SHAWN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265431258
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2775 SCHOENERSVILLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHLEHEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18017-7307
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-861-8080
Provider Business Mailing Address Fax Number:
610-807-0366

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 N 17TH ST
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-5044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-439-8500
Provider Business Practice Location Address Fax Number:
610-439-1320
Provider Enumeration Date:
07/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT017060 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 329148 . This is a "HEALTHAMERICA/HEALTHASSUR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7518605 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2313108000 . This is a "KEYSTONE HEALTH EAST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2313108000 . This is a "INDEPENDENCE BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2170527 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 818472 . This is a "FIRST PRIORITY HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 47241 . This is a "GEISINGER HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8916194 . This is a "CIGNA HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P3395930 . This is a "OXFORD HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1638384 . This is a "HIGHMARK BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2313108000 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 50047055 . This is a "KEYSTONE HEALTH CENTRAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00153829 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1638384 . This is a "FIRST PRIORITY LIFE INS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2461388 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 50047055 . This is a "CAPITAL BLUE CROSS" identifier . This identifiers is of the category "OTHER".




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