Healthcare Provider Details

I. General information

NPI: 1588968739
Provider Name (Legal Business Name): SAGINE FLORNA MAIGNAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2011
Last Update Date: 11/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

484 TEMPLE HILL RD
NEW WINDSOR NY
12553-5557
US

IV. Provider business mailing address

2475 SAINT RAYMONDS AVE
BRONX NY
10461-3124
US

V. Phone/Fax

Practice location:
  • Phone: 845-565-3700
  • Fax: 845-565-3308
Mailing address:
  • Phone: 845-565-3700
  • Fax: 845-565-3308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number020344
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number626340-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: