1730112848 NPI number — DR. L. CELIA MALMAD D.C.

Table of content: DR. L. CELIA MALMAD D.C. (NPI 1730112848)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730112848 NPI number — DR. L. CELIA MALMAD D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MALMAD
Provider First Name:
L.
Provider Middle Name:
CELIA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

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:
1730112848
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 299
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
QUAKERTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18951-0299
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-538-2980
Provider Business Mailing Address Fax Number:
215-538-3588

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
318 N WEST END BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
QUAKERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18951-2310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-538-2980
Provider Business Practice Location Address Fax Number:
215-538-3588
Provider Enumeration Date:
07/09/2006

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: 111NX0800X , with the licence number:  DC-002280L , 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: 0023351000 . This is a "HMO IDENTIFIER NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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