Provider Demographics
NPI:1124012844
Name:MAISEL, BARRY OSCAR (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:OSCAR
Last Name:MAISEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:414 MAPLE AVE
Mailing Address - Street 2:#600
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-5550
Mailing Address - Country:US
Mailing Address - Phone:518-583-1553
Mailing Address - Fax:518-583-2656
Practice Address - Street 1:414 MAPLE AVE
Practice Address - Street 2:#600
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-5550
Practice Address - Country:US
Practice Address - Phone:518-583-1553
Practice Address - Fax:518-583-2656
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-08
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149025207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00976274Medicaid
NY50114AMedicare ID - Type Unspecified
NY00976274Medicaid