Healthcare Provider Details

I. General information

NPI: 1225539224
Provider Name (Legal Business Name): ANIQA ARIF MALIK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2018
Last Update Date: 10/27/2021
Certification Date: 10/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S 21ST ST
EASTON PA
18042-3851
US

IV. Provider business mailing address

2100 MACK BLVD
ALLENTOWN PA
18103-5622
US

V. Phone/Fax

Practice location:
  • Phone: 610-250-4000
  • Fax:
Mailing address:
  • Phone: 484-884-0617
  • Fax: 484-884-0628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT214776
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD475412
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: