Provider Demographics
NPI:1912113747
Name:MAALIKI, OMAIMA ATAYA (MD)
Entity Type:Individual
Prefix:DR
First Name:OMAIMA
Middle Name:ATAYA
Last Name:MAALIKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 CHESTNUT HILL AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-4671
Mailing Address - Country:US
Mailing Address - Phone:617-319-1370
Mailing Address - Fax:
Practice Address - Street 1:72 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2738
Practice Address - Country:US
Practice Address - Phone:978-745-3050
Practice Address - Fax:978-745-7014
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231283208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics