Provider Demographics
NPI:1376816066
Name:MALTSEVA, TATYANA (LIC ACUPUNCTURIST)
Entity Type:Individual
Prefix:
First Name:TATYANA
Middle Name:
Last Name:MALTSEVA
Suffix:
Gender:F
Credentials:LIC ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SUNNYKING DR
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-6125
Mailing Address - Country:US
Mailing Address - Phone:410-526-9111
Mailing Address - Fax:410-526-9111
Practice Address - Street 1:8 GREENSPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4136
Practice Address - Country:US
Practice Address - Phone:410-654-8997
Practice Address - Fax:410-654-8449
Is Sole Proprietor?:No
Enumeration Date:2012-02-12
Last Update Date:2012-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00745171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist