MEDICARE: DR. MAYER MALTZ R.PH.

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	183500000X	Pharmacist	043884	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740332873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAYER MALTZ R.PH.

Provider Business Mailing Address
First Line	:	914 EILEEN TER
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-1519
Country	:	US
Telephone Number	:	347-680-2464
Fax Number	:

Provider Business Practice Location Address
First Line	:	4624 NEW UTRECHT AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-2545
Country	:	US
Telephone Number	:	718-436-9300
Fax Number	:

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	07/08/2007

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