Healthcare Provider Details

I. General information

NPI: 1548900541
Provider Name (Legal Business Name): BYRON SAMUEL MCGARRY-MALTEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BYRON MALTEZ MD

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2094 PITKIN AVE
BROOKLYN NY
11207-3509
US

IV. Provider business mailing address

2094 PITKIN AVE
BROOKLYN NY
11207-3509
US

V. Phone/Fax

Practice location:
  • Phone: 844-692-4692
  • Fax: 718-240-0623
Mailing address:
  • Phone: 844-692-4692
  • Fax: 718-240-0623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number346815
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number346815
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: