Provider Demographics
NPI:1376881771
Name:MALKA, TALIA (RAC, LAC)
Entity type:Individual
Prefix:
First Name:TALIA
Middle Name:
Last Name:MALKA
Suffix:
Gender:F
Credentials:RAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4026 WOODRUFF RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-1618
Mailing Address - Country:US
Mailing Address - Phone:610-825-8767
Mailing Address - Fax:
Practice Address - Street 1:4026 WOODRUFF RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-1618
Practice Address - Country:US
Practice Address - Phone:610-825-8767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000212L171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist