Provider Demographics
NPI:1881677656
Name:MALESKI, RICHARD M (DPM)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:M
Last Name:MALESKI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003004L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1163969Medicaid
PAT82281OtherUPIN
PA1391821OtherUNITED MINEWORKERS
PA1163969Medicaid