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NPI Code Detail

MEDICARE: WENDY MAIELLO

MEDICARE: WENDY MAIELLO
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
1183500000XPharmacist20 049604NY

General Provider Information

NPI Number : 1841562485
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY MAIELLO
Provider Business Mailing Address
First Line : 61 MANN AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-4421
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 260 ARDEN AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10312-1229
Country : US
Telephone Number : 718-966-5509
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2012
Last Update Date : 01/28/2012

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Directions to “ WENDY MAIELLO ” Practice Location

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