Provider Demographics
NPI:1730559931
Name:MALONEY, EMERY JAMES (CO)
Entity type:Individual
Prefix:
First Name:EMERY
Middle Name:JAMES
Last Name:MALONEY
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 CARDINAL LN STE 110
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54313-9587
Mailing Address - Country:US
Mailing Address - Phone:920-940-5277
Mailing Address - Fax:844-308-8462
Practice Address - Street 1:445 CARDINAL LN STE 110
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54313-9587
Practice Address - Country:US
Practice Address - Phone:920-940-5277
Practice Address - Fax:844-308-8462
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist