Provider Demographics
NPI:1679198188
Name:ABDUL-MALAK, JOSEPH ELIAS (MD, MBA)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ELIAS
Last Name:ABDUL-MALAK
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 SHENANGO VALLEY FWY STE A-2
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-2586
Mailing Address - Country:US
Mailing Address - Phone:724-347-4561
Mailing Address - Fax:
Practice Address - Street 1:2151 SHENANGO VALLEY FWY STE A-2
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-2586
Practice Address - Country:US
Practice Address - Phone:724-347-4561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4857790207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology