Provider Demographics
NPI:1942879614
Name:MALONEY, AMIRAH (LPN, CBC)
Entity Type:Individual
Prefix:
First Name:AMIRAH
Middle Name:
Last Name:MALONEY
Suffix:
Gender:F
Credentials:LPN, CBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 E STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-2426
Mailing Address - Country:US
Mailing Address - Phone:267-694-1480
Mailing Address - Fax:
Practice Address - Street 1:99 E STEWART AVE
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-2426
Practice Address - Country:US
Practice Address - Phone:267-694-1480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN313326164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPN313326Medicaid