Doctor Name: | JOHN A MALARA |
NPI Number: | 1083689608 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | MA052370 |
Business Practice Address: | 1601 Medical Dr Pottstown, PA - 194643241 |
Business Phone Number: | 6107053055 |
Business Fax Number: | 6107055790 |
Mailing Address: | 1569 Medical Dr, Suite 202 POTTSTOWN |
State: | PA |
Postal Code: | 194643223 |
Phone Number: | 6103274200 |
Fax Number: | 6103278160 |
NPI Enumeration Date: | 02/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | MA052370 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |