Provider Demographics
NPI:1114928785
Name:MALETTO, THUDUYEN P (PTA)
Entity Type:Individual
Prefix:MRS
First Name:THUDUYEN
Middle Name:P
Last Name:MALETTO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:DUYEN
Other - Middle Name:N
Other - Last Name:PHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:46 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-9788
Mailing Address - Country:US
Mailing Address - Phone:610-678-3460
Mailing Address - Fax:
Practice Address - Street 1:1011 W PENN AVE
Practice Address - Street 2:
Practice Address - City:ROBESONIA
Practice Address - State:PA
Practice Address - Zip Code:19551-9550
Practice Address - Country:US
Practice Address - Phone:610-589-2263
Practice Address - Fax:610-589-2232
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE 005840L225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant