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General NPI Number Information
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NPI Number | 1801191127
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Entity Type | Organization
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Legal Business Name | VINCENT J MALKOVITS DO LLC
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Dates
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Enumeration Date | 01/18/2011
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 25 N CANFIELD NILES RD SUITE #160
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City | YOUNGSTOWN
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State | OH
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Zip | 44515-2328
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Country | US
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Telephone | 330-792-2976
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Fax | 330-792-8707
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Provider Business Mailing Address
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Address Line | 25 N CANFIELD NILES RD SUITE #160
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City | YOUNGSTOWN
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State | OH
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Zip | 44515-2328
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Country | US
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Telephone | 330-792-2976
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Fax | 330-792-8707
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VINCENT J MALKOVITS
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Credential | D.O.
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Telephone | 330-792-2976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 34006675
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License Number State | OH
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