Provider Demographics
NPI:1245201664
Name:MALISZEWSKI, ELIZABETH (P A)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MALISZEWSKI
Suffix:
Gender:F
Credentials:P A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 HOLIDAY DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-2727
Mailing Address - Country:US
Mailing Address - Phone:412-444-0098
Mailing Address - Fax:412-444-0111
Practice Address - Street 1:127 ONEIDA VALLEY RD
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-2239
Practice Address - Country:US
Practice Address - Phone:724-282-4370
Practice Address - Fax:724-431-2288
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA050810363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA277005OtherFEDERAL BLACK LUNG
PA970024718OtherMEDICARE RAILROAD
PA055211Medicare ID - Type Unspecified
PA970024718OtherMEDICARE RAILROAD