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General NPI Number Information
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NPI Number | 1316988942
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Entity Type | Individual
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Provider Name | RICHARD I. MALKIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 9501 ROOSEVELT BLVD SUITE 410
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City | PHILADELPHIA
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State | PA
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Zip | 19114-1025
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Country | US
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Telephone | 215-969-4917
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Fax | 215-969-5875
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Provider Business Mailing Address
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Address Line | P. O. BOX 8500 - 6335
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City | PHILADELPHIA
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State | PA
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Zip | 19178-0001
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Country | US
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Telephone | 215-807-8000
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Fax | 215-807-8235
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD020683E
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License Number State | PA
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