Provider Demographics
NPI:1578733820
Name:MALETTA, DENISE A (LAC/LMT)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:A
Last Name:MALETTA
Suffix:
Gender:F
Credentials:LAC/LMT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 44
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-0044
Mailing Address - Country:US
Mailing Address - Phone:631-757-6555
Mailing Address - Fax:631-757-6555
Practice Address - Street 1:114 WALL STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-0000
Practice Address - Country:US
Practice Address - Phone:631-673-5433
Practice Address - Fax:631-673-5435
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001812-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist