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General NPI Number Information
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NPI Number | 1366355521
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Entity Type | Organization
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Legal Business Name | MAISON MEDICAL PLLC
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 619 N MIDLAND AVE
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City | NYACK
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State | NY
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Zip | 10960-1031
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Country | US
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Telephone | 845-535-9122
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Fax |
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Provider Business Mailing Address
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Address Line | 619 N MIDLAND AVE
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City | NYACK
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State | NY
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Zip | 10960-1031
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Country | US
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Telephone | 845-535-9122
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. JAKUB PAWEL BARTNIK
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Credential | DO
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Telephone | 845-535-9122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State | NULL
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