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NPI Code Detail

MEDICARE: MAYGAN PROCINO

MEDICARE: MAYGAN PROCINO
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
1367500000XCertified Registered Nurse Anesthetist719622NY

General Provider Information

NPI Number : 1164252201
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYGAN PROCINO
Provider Business Mailing Address
First Line : 4103 MASONWOOD CT
Second Line :
City : SNELLVILLE
State : GA
Zip : 30039-6955
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4103 MASONWOOD CT
Second Line :
City : SNELLVILLE
State : GA
Zip : 30039-6955
Country : US
Telephone Number : 631-942-6328
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2024
Last Update Date : 01/14/2026

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Directions to “ MAYGAN PROCINO ” Practice Location

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