Provider Demographics
NPI:1235144973
Name:RAYSON, MAUREEN M (CNM, MS)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:M
Last Name:RAYSON
Suffix:
Gender:F
Credentials:CNM, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W 23RD ST APT 8A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2174
Mailing Address - Country:US
Mailing Address - Phone:646-230-7708
Mailing Address - Fax:212-463-9526
Practice Address - Street 1:135 W 27TH ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6226
Practice Address - Country:US
Practice Address - Phone:646-230-7708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000409176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01504172Medicaid