Provider Demographics
NPI:1952960148
Name:MALIK, MOHAMMAD S
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:S
Last Name:MALIK
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 1:220 HOPEWELL PRINCETON RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08525-2306
Mailing Address - Country:US
Mailing Address - Phone:609-233-1443
Mailing Address - Fax:
Practice Address - Street 1:3501 NEWBERRY RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-2608
Practice Address - Country:US
Practice Address - Phone:609-233-1443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health