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NPI Code Detail

MEDICARE: LEE-ANNE ELISA MAXIMO

MEDICARE: LEE-ANNE ELISA MAXIMO
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
1104100000XSocial Worker122741NY

General Provider Information

NPI Number : 1619802568
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEE-ANNE ELISA MAXIMO
Provider Business Mailing Address
First Line : 1718 PURDY ST APT 2G
Second Line :
City : BRONX
State : NY
Zip : 10462-6333
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 234 E 149TH ST
Second Line :
City : BRONX
State : NY
Zip : 10451-5504
Country : US
Telephone Number : 718-579-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2026
Last Update Date : 06/15/2026

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Directions to “ LEE-ANNE ELISA MAXIMO ” Practice Location

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