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NPI Code Detail

MEDICARE: BRINA A MALDONADO MD

MEDICARE: BRINA A MALDONADO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician204890NY

General Provider Information

NPI Number : 1780672378
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRINA A MALDONADO MD
Provider Business Mailing Address
First Line : PO BOX 2003
Second Line :
City : EAST SYRACUSE
State : NY
Zip : 13057-4503
Country : US
Telephone Number : 315-446-3904
Fax Number : 315-445-2936
Provider Business Practice Location Address
First Line : 135 SPRING ST
Second Line : 2ND FL
City : NEW YORK
State : NY
Zip : 10012-3858
Country : US
Telephone Number : 212-219-1187
Fax Number : 212-219-1538
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2005
Last Update Date : 07/08/2007

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