Provider Demographics
NPI:1710007539
Name:ORLANDO Z. MALOLES JR. MD
Entity Type:Organization
Organization Name:ORLANDO Z. MALOLES JR. MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:Z
Authorized Official - Last Name:MALOLES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:610-734-1198
Mailing Address - Street 1:339 LONG LN
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-4001
Mailing Address - Country:US
Mailing Address - Phone:610-734-1198
Mailing Address - Fax:610-734-2328
Practice Address - Street 1:339 LONG LN
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-4001
Practice Address - Country:US
Practice Address - Phone:610-734-1198
Practice Address - Fax:610-734-2328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039348L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB34465Medicare UPIN