Healthcare Provider Details

I. General information

NPI: 1306144563
Provider Name (Legal Business Name): MAUREEN SKYERS-MARTIN RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2011
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 55TH ST
BROOKLYN NY
11220-2559
US

IV. Provider business mailing address

1548 E 56TH ST
BROOKLYN NY
11234-4002
US

V. Phone/Fax

Practice location:
  • Phone: 718-630-7185
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number431174
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF335307
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: