Provider Demographics
NPI:1396955746
Name:MALECKA, JAMES JOSEPH (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOSEPH
Last Name:MALECKA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 N MAIN ST
Mailing Address - Street 2:SUITE A-6
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-1481
Mailing Address - Country:US
Mailing Address - Phone:856-629-8144
Mailing Address - Fax:856-629-3680
Practice Address - Street 1:375 N MAIN ST
Practice Address - Street 2:SUITE A-6
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-1481
Practice Address - Country:US
Practice Address - Phone:856-629-8144
Practice Address - Fax:856-629-3680
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB03500900208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMA428416Medicare ID - Type Unspecified
NJE79660Medicare UPIN