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Individual

KATELIN MALISHCHAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
425 EAST FIRST ST., BLOOMSBURG, PA 17815-6183
(570) 416-1890
(570) 416-1892
Mailing address
100 NORTH ACADEMY AVE., DANVILLE, PA 17822-4903
(570) 271-6144

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA054998
PA
363AM0700X
Medical Physician Assistant
MA054998
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
227084
MEDICARE
PA
Enumeration date
07/25/2011
Last updated
03/15/2016
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