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General NPI Number Information
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NPI Number | 1386034023
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Entity Type | Organization
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Legal Business Name | MAYNARD ORTHOPEDICS, PLLC
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Dates
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Enumeration Date | 02/03/2015
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 520 E 72ND ST STE LCD
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City | NEW YORK
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State | NY
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Zip | 10021-4849
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Country | US
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Telephone | 212-259-0436
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Fax |
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Provider Business Mailing Address
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Address Line | 520 E 72ND ST STE LCD
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City | NEW YORK
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State | NY
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Zip | 10021-4849
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Country | US
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Telephone | 212-259-0436
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MICHAEL J MAYNARD
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Credential | MD
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Telephone | 212-259-0436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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