Provider Demographics
NPI:1821006578
Name:RICHARD M. MALESKI DPM PC
Entity Type:Organization
Organization Name:RICHARD M. MALESKI DPM PC
Other - Org Name:RICHARD M MALESKI DPM
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MALESKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:724-337-4433
Mailing Address - Street 1:2021 FREEPORT RD
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:PA
Mailing Address - Zip Code:15068-4809
Mailing Address - Country:US
Mailing Address - Phone:724-337-4433
Mailing Address - Fax:724-337-4489
Practice Address - Street 1:2021 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:PA
Practice Address - Zip Code:15068-4809
Practice Address - Country:US
Practice Address - Phone:724-337-4433
Practice Address - Fax:724-337-4489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003004L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1391821OtherUMW
PA1163969Medicaid
PA1163969Medicaid
PA103543Medicare PIN