Provider Demographics
NPI:1093289159
Name:MALECKI, AARON
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:MALECKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AARON
Other - Middle Name:
Other - Last Name:LEADER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AARON LEADER
Mailing Address - Street 1:25700 HILL RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21639-1517
Mailing Address - Country:US
Mailing Address - Phone:443-205-0628
Mailing Address - Fax:
Practice Address - Street 1:420 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-3055
Practice Address - Country:US
Practice Address - Phone:410-479-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA4340225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant