MEDICARE: MS. MAISHA E MAITLAND-JONES

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
1	363LG0600X	Gerontology Nurse Practitioner	340640	NY

General Provider Information

NPI Number	:	1184830036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MAISHA E MAITLAND-JONES

Provider Business Mailing Address
First Line	:	PO BOX 746087
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6087
Country	:	US
Telephone Number	:	312-733-9730
Fax Number	:

Provider Business Practice Location Address
First Line	:	8923 FLATLANDS AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3613
Country	:	US
Telephone Number	:	718-765-6000
Fax Number	:	347-436-9621

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	01/21/2025

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