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General NPI Number Information
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NPI Number | 1568197606
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Entity Type | Individual
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Provider Name | MIRANDA CARINA MALDONADO DNP, MSN
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Gender | Female
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Dates
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Enumeration Date | 07/22/2022
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Last Update Date | 11/04/2026
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Provider Practice Location Address
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Address Line | 400 RELLA BLVD STE 165
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City | SUFFERN
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State | NY
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Zip | 10901-4241
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Country | US
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Telephone | 845-259-6881
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Fax | 201-648-2667
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Provider Business Mailing Address
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Address Line | 210 RIVER ST STE 24
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City | HACKENSACK
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State | NJ
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Zip | 07601-7504
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Country | US
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Telephone | 551-298-6971
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR22320100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F404269
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ15273700
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 803946
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License Number State | NY
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