Healthcare Provider Details

I. General information

NPI: 1851397954
Provider Name (Legal Business Name): JOSEPH C MALONEY III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 04/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7996 OXFORD AVE
PHILADELPHIA PA
19111-2241
US

IV. Provider business mailing address

7996 OXFORD AVE
PHILADELPHIA PA
19111-2241
US

V. Phone/Fax

Practice location:
  • Phone: 215-728-1411
  • Fax: 215-745-7578
Mailing address:
  • Phone: 215-728-1411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD029778E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: