Provider Demographics
NPI:1306979943
Name:MALAND, SUSAN E (CFOM)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:E
Last Name:MALAND
Suffix:
Gender:F
Credentials:CFOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7371 FAIRWEATHER DRIVE
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:PA
Mailing Address - Zip Code:16415
Mailing Address - Country:US
Mailing Address - Phone:814-474-4757
Mailing Address - Fax:
Practice Address - Street 1:7371 FAIRWEATHER DRIVE
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:PA
Practice Address - Zip Code:16415
Practice Address - Country:US
Practice Address - Phone:814-474-4757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier