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General NPI Number Information
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NPI Number | 1386725323
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Entity Type | Individual
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Provider Name | DR. ROBERT JOSEPH MAIDEN
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Gender | Male
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 10/01/2019
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Provider Practice Location Address
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Address Line | 12 MARTIN ST SUITE 3
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City | WELLSVILLE
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State | NY
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Zip | 14895
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Country | US
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Telephone | 585-593-1859
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Fax | 585-593-2465
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Provider Business Mailing Address
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Address Line | 12 MARTIN ST, SUITE 3 SUITE 3
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City | WELLSVILLE
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State | NY
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Zip | 14895
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Country | US
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Telephone | 585-593-9815
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Fax | 585-596-4048
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 006688-2
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 006688
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License Number State | NY
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