Provider Demographics
NPI:1215178983
Name:MALETZKY, SIDNEY P (DO)
Entity Type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:P
Last Name:MALETZKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 LAKEVIEW PL
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1116
Mailing Address - Country:US
Mailing Address - Phone:856-751-6625
Mailing Address - Fax:
Practice Address - Street 1:11 LAKEVIEW PL
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1116
Practice Address - Country:US
Practice Address - Phone:856-751-6625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB01897600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine