Provider Demographics
NPI:1053666479
Name:QUESADA, MAUREEN FAITH MACASINAG (RN)
Entity Type:Individual
Prefix:
First Name:MAUREEN FAITH
Middle Name:MACASINAG
Last Name:QUESADA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3102 76TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1823
Mailing Address - Country:US
Mailing Address - Phone:347-393-4141
Mailing Address - Fax:
Practice Address - Street 1:3102 76TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1823
Practice Address - Country:US
Practice Address - Phone:347-393-4141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY601928-1163W00000X
NJ26NR13837200163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse