Provider Demographics
NPI:1760577191
Name:MALONE, RICHARD (CPO)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:MALONE
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 OLD YORK ROAD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046
Mailing Address - Country:US
Mailing Address - Phone:215-886-0185
Mailing Address - Fax:215-886-0186
Practice Address - Street 1:801 OLD YORK ROAD
Practice Address - Street 2:SUITE 315
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046
Practice Address - Country:US
Practice Address - Phone:215-886-0185
Practice Address - Fax:215-886-0186
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist