Provider Demographics
NPI:1154684280
Name:KLOEPFER, MAIA VENTURI (MS ED)
Entity Type:Individual
Prefix:
First Name:MAIA
Middle Name:VENTURI
Last Name:KLOEPFER
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:MAIA
Other - Middle Name:
Other - Last Name:VENTURI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:58 LYONS RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5724
Mailing Address - Country:US
Mailing Address - Phone:914-625-6114
Mailing Address - Fax:
Practice Address - Street 1:58 LYONS RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5724
Practice Address - Country:US
Practice Address - Phone:914-625-6114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist