Provider Demographics
NPI:1285651273
Name:BALEANU-MALLOZZI, RALUCA I (MD)
Entity Type:Individual
Prefix:
First Name:RALUCA
Middle Name:I
Last Name:BALEANU-MALLOZZI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 CROSSWICK LANE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-5324
Mailing Address - Country:US
Mailing Address - Phone:717-945-7227
Mailing Address - Fax:717-945-7228
Practice Address - Street 1:135 CROSSWICK LANE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-5324
Practice Address - Country:US
Practice Address - Phone:717-945-7227
Practice Address - Fax:717-945-7228
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043093L208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
E98856Medicare UPIN
PABA686173Medicare ID - Type Unspecified