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General NPI Number Information
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NPI Number | 1760152912
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Entity Type | Individual
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Provider Name | MAXIANA LOUIS NP-C
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Gender | Female
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Dates
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Enumeration Date | 09/19/2021
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 1752 FRANCIS LEWIS BLVD
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City | WHITESTONE
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State | NY
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Zip | 11357-3247
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Country | US
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Telephone | 718-746-9494
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Fax |
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Provider Business Mailing Address
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Address Line | 884 WASHINGTON ST
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City | BALDWIN
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State | NY
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Zip | 11510-4635
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Country | US
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Telephone | 347-217-6772
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 310381
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | F310381-01
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | F310381-01
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License Number State | NJ
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