Provider Demographics
NPI:1336272640
Name:MALANGA, THOMAS E (DC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:MALANGA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 BLOOMFIELD AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1600
Mailing Address - Country:US
Mailing Address - Phone:973-239-4111
Mailing Address - Fax:973-239-9105
Practice Address - Street 1:685 BLOOMFIELD AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-1600
Practice Address - Country:US
Practice Address - Phone:973-239-4111
Practice Address - Fax:973-239-9105
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00256800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ520216Medicare PIN