Healthcare Provider Details

I. General information

NPI: 1619415676
Provider Name (Legal Business Name): MAASER CD PAP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 05/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 BRIGHTON BEACH AVE FL 3
BROOKLYN NY
11235-5558
US

IV. Provider business mailing address

180 WEST END AVENUE APT. 15G
NEW YORK NY
10023
US

V. Phone/Fax

Practice location:
  • Phone: 718-427-5265
  • Fax:
Mailing address:
  • Phone: 718-427-5265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: VIOLETTA LIVSHIZ
Title or Position: DIRECTOR
Credential:
Phone: 718-427-5265