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NPI Code Detail

MEDICARE: SPRING OBGYN PC

MEDICARE: SPRING OBGYN PC
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
1207V00000XObstetrics & Gynecology Physician

General Provider Information

NPI Number : 1235127820
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPRING OBGYN PC
Provider Business Mailing Address
First Line : P.O. BOX 12122
Second Line :
City : BELFAST
State : ME
Zip : 04915-4012
Country : US
Telephone Number : 212-219-1187
Fax Number : 212-219-1538
Provider Business Practice Location Address
First Line : 135 SPRING ST
Second Line : 2ND FLOOR
City : NEW YORK
State : NY
Zip : 10012-3858
Country : US
Telephone Number : 212-219-1187
Fax Number : 212-219-1538
Authorized Official
Title or Position : PRESIDENT
Name : BRINA MALDONADO
Credential : MD
Telephone Number : 212-219-1187
Provider Enumeration Date : 10/09/2005
Last Update Date : 06/08/2022

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