Provider Demographics
NPI:1720286503
Name:GERALD MALONEY DO PC
Entity Type:Organization
Organization Name:GERALD MALONEY DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNP
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HIRTHLER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:570-825-8780
Mailing Address - Street 1:166 HANOVER ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-3549
Mailing Address - Country:US
Mailing Address - Phone:570-825-8780
Mailing Address - Fax:570-825-8785
Practice Address - Street 1:166 HANOVER ST
Practice Address - Street 2:SUITE 203
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-3549
Practice Address - Country:US
Practice Address - Phone:570-825-8780
Practice Address - Fax:570-825-8785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty