Healthcare Provider Details

I. General information

NPI: 1518959212
Provider Name (Legal Business Name): ADAM W MAUER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1165 NORTHERN BLVD SUITE 303
MANHASSET NY
11030-3048
US

IV. Provider business mailing address

1165 NORTHERN BLVD SUITE 303
MANHASSET NY
11030-3048
US

V. Phone/Fax

Practice location:
  • Phone: 516-627-0303
  • Fax: 516-627-1399
Mailing address:
  • Phone: 516-627-0303
  • Fax: 516-627-1399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number227736
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number227736
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: