Provider Demographics
NPI:1164564878
Name:MALDONADO, RAQUEL (RNC)
Entity Type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CEDAR LANE
Mailing Address - Street 2:
Mailing Address - City:THIELLS
Mailing Address - State:NY
Mailing Address - Zip Code:10984-1211
Mailing Address - Country:US
Mailing Address - Phone:845-947-1715
Mailing Address - Fax:845-429-4639
Practice Address - Street 1:175 TARRYTOWN ROAD
Practice Address - Street 2:PLANNED PARENTHOOD HUMAN RESOURCE OFFICE
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1616
Practice Address - Country:US
Practice Address - Phone:914-761-6566
Practice Address - Fax:914-948-0010
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF4200371363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner