Healthcare Provider Details

I. General information

NPI: 1467071563
Provider Name (Legal Business Name): PAUL JASON MALONEY RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 04/09/2020
Certification Date: 04/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 AUBURN AVE
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

4188 FORSYTHIA DR
CINCINNATI OH
45245-1606
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-2000
  • Fax:
Mailing address:
  • Phone: 513-602-9885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRCP.13119
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: