Healthcare Provider Details

I. General information

NPI: 1750460002
Provider Name (Legal Business Name): MARGARET CAROLYN MALECKA RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 10/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 CRESCENT WAY
CHERRY HILL NJ
08002-4278
US

IV. Provider business mailing address

2035 CRESCENT WAY
CHERRY HILL NJ
08002-4278
US

V. Phone/Fax

Practice location:
  • Phone: 856-985-9375
  • Fax:
Mailing address:
  • Phone: 973-957-0551
  • Fax: 866-396-3054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number26NR06899400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: