Provider Demographics
NPI:1487025052
Name:SVETLANA MALINSKY, DPM PC
Entity Type:Organization
Organization Name:SVETLANA MALINSKY, DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-474-1933
Mailing Address - Street 1:6201 GREENBELT RD
Mailing Address - Street 2:SUITE M-8A
Mailing Address - City:BERWYN HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20740-2354
Mailing Address - Country:US
Mailing Address - Phone:301-474-1933
Mailing Address - Fax:
Practice Address - Street 1:20410 OBSERVATION DR STE 210
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-6422
Practice Address - Country:US
Practice Address - Phone:301-474-1933
Practice Address - Fax:301-441-9233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01406332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0136949102Medicaid