Provider Demographics
NPI:1841714599
Name:MALAKA, MORLEY
Entity type:Individual
Prefix:MR
First Name:MORLEY
Middle Name:
Last Name:MALAKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8671 BRAXTED LN
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4579
Mailing Address - Country:US
Mailing Address - Phone:703-962-0211
Mailing Address - Fax:
Practice Address - Street 1:14904 JEFFERSON DAVIS HWY STE 105
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3908
Practice Address - Country:US
Practice Address - Phone:703-490-8171
Practice Address - Fax:703-490-8171
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor