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General NPI Number Information
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NPI Number | 1366711103
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Entity Type | Individual
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Provider Name | JOSE MICHAEL MARIA NP, RN
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Gender | Male
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Dates
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Enumeration Date | 12/23/2011
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 489 5TH AVE FL 3
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City | NEW YORK
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State | NY
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Zip | 10017-6145
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Country | US
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Telephone | 888-663-6331
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Fax | 415-252-7176
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Provider Business Mailing Address
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Address Line | 3184 GRAND CONCOURSE APT 2D
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City | BRONX
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State | NY
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Zip | 10458-1031
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Country | US
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Telephone | 646-389-8369
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Fax | 646-553-4126
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 339074
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 617047
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License Number State | NY
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