Provider Demographics
NPI:1558764639
Name:MAALOUF, GEORGE (R PH)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:MAALOUF
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 FIRST AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-4505
Mailing Address - Country:US
Mailing Address - Phone:215-353-1811
Mailing Address - Fax:
Practice Address - Street 1:202 FIRST AVE
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-4505
Practice Address - Country:US
Practice Address - Phone:215-353-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039297R183500000X
PARP1003354183500000X
NY033422-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist