Provider Demographics
NPI:1245250315
Name:MALEYKO, RAYMOND JR (ATC)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:
Last Name:MALEYKO
Suffix:JR
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28888 WESTFIELD ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-3137
Mailing Address - Country:US
Mailing Address - Phone:734-421-0508
Mailing Address - Fax:
Practice Address - Street 1:8400 N BECK RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-1210
Practice Address - Country:US
Practice Address - Phone:734-582-5697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI22OtherCERTIFIED ATHLETIC TRAINE