Healthcare Provider Details

I. General information

NPI: 1891744314
Provider Name (Legal Business Name): MAYA HAMBRIGHT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 08/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FAMILY PRACTICE DR
KINGSTON NY
12401-6449
US

IV. Provider business mailing address

279 MAIN ST SUITE 204
NEW PALTZ NY
12561-1623
US

V. Phone/Fax

Practice location:
  • Phone: 845-338-6400
  • Fax: 845-339-7288
Mailing address:
  • Phone: 845-255-3046
  • Fax: 845-255-0236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number223733
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: