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NPI Code Detail

MEDICARE: MAXINE SEALEY FNP

MEDICARE:   MAXINE  SEALEY  FNP
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
1363LF0000XFamily Nurse PractitionerF341042-1NY

General Provider Information

NPI Number : 1902331713
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAXINE SEALEY FNP
Provider Business Mailing Address
First Line : 5711 TILDEN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-4821
Country : US
Telephone Number : 718-629-9356
Fax Number : 718-629-9356
Provider Business Practice Location Address
First Line : 5711 TILDEN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-4821
Country : US
Telephone Number : 718-629-9356
Fax Number : 718-629-9356
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2017
Last Update Date : 04/30/2017

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Directions to “ MAXINE SEALEY FNP” Practice Location

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