Healthcare Provider Details

I. General information

NPI: 1326490418
Provider Name (Legal Business Name): MAXMATH TUTORING ONLINE INC., NY BRANCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 07/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 GARDEN CITY AVE
WYANDANCH NY
11798-3010
US

IV. Provider business mailing address

31 GARDEN CITY AVE
WYANDANCH NY
11798-3010
US

V. Phone/Fax

Practice location:
  • Phone: 888-959-4159
  • Fax: 888-959-4173
Mailing address:
  • Phone: 888-959-4159
  • Fax: 888-959-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JEAN MAXCENE DECARDE
Title or Position: PRESIDENT
Credential:
Phone: 888-959-4159