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NPI Code Detail

MEDICARE: MS. MAUREEN ANNE STARK MSED.

MEDICARE:  MS. MAUREEN ANNE STARK  MSED.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistNY

General Provider Information

NPI Number : 1104188804
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MAUREEN ANNE STARK MSED.
Provider Business Mailing Address
First Line : 3207 RONIT CT
Second Line :
City : YORKTOWN HEIGHTS
State : NY
Zip : 10598-1933
Country : US
Telephone Number : 914-438-3133
Fax Number :
Provider Business Practice Location Address
First Line : 3207 RONIT CT
Second Line :
City : YORKTOWN HEIGHTS
State : NY
Zip : 10598-1933
Country : US
Telephone Number : 914-438-3133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2012
Last Update Date : 06/09/2012

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Directions to “ MS. MAUREEN ANNE STARK MSED.” Practice Location

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