Provider Demographics
NPI:1699742296
Name:MALONEY, CHARLENE MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:CHARLENE
Middle Name:MARIE
Last Name:MALONEY
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:2591 WEXFORD BAYNE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-8676
Mailing Address - Country:US
Mailing Address - Phone:724-933-5588
Mailing Address - Fax:724-933-6051
Practice Address - Street 1:2591 WEXFORD BAYNE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-8676
Practice Address - Country:US
Practice Address - Phone:724-933-5588
Practice Address - Fax:724-933-6051
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2007-08-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOEG001629152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist