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Individual

RAYMOND J MALTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2201 CHAPEL AVE W, CHERRY HILL, NJ 08002-2048
(856) 488-6816
(856) 488-6511
Mailing address
307 S EVERGREEN AVE, WOODBURY, NJ 08096-2739
(856) 686-4300

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MB59354
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
223586506
CHAMPUS/TRICARE
NJ
05
6930204
NJ
Enumeration date
06/06/2006
Last updated
07/16/2007
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