Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | MD039348L | PA |
NPI | 1336102128 |
---|---|
Provider Name | Dr. Orlando Zoleta Maloles JR. |
First Address | Upper Darby, PA 19082-4001 |
Second Address | Upper Darby, PA 19082-4001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B34465 | (02) | PA |