Healthcare Provider Details

I. General information

NPI: 1306806294
Provider Name (Legal Business Name): KAITLIN G MALONEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAITLIN G KUZNIEWSKI PA-C

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S 21ST ST
EASTON PA
18042-3851
US

IV. Provider business mailing address

250 S 21ST ST
EASTON PA
18042-3851
US

V. Phone/Fax

Practice location:
  • Phone: 610-250-4000
  • Fax: 610-402-3184
Mailing address:
  • Phone: 610-250-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA052180
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA052180
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: