Doctor Name: | MRS. CONSTANCE M MAUE |
NPI Number: | 1073881173 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | REGISTERED NURSE |
License Number: | 243445-1 |
Business Practice Address: | 6050 Fairway Ct Lake View, NY - 140859568 |
Business Phone Number: | 7169261771 |
Business Fax Number: | 7169261755 |
Mailing Address: | 6050 Fairway Ct, LAKE VIEW |
State: | NY |
Postal Code: | 140859568 |
Phone Number: | 7169261771 |
Fax Number: | 7169261755 |
NPI Enumeration Date: | 12/05/2011 |
NPI Last Update Date: | 12/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WS0200X |
License Number: | 243445-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | School |
Taxonomy Definition: |