Provider Demographics
NPI:1275532822
Name:WING, MARIA L (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:L
Last Name:WING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1333A NORTH AVE
Mailing Address - Street 2:PMB 426
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-2120
Mailing Address - Country:US
Mailing Address - Phone:914-235-8224
Mailing Address - Fax:
Practice Address - Street 1:77 QUAKER RIDGE RD
Practice Address - Street 2:SUITE 200A
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-2808
Practice Address - Country:US
Practice Address - Phone:914-235-8224
Practice Address - Fax:914-235-6940
Is Sole Proprietor?:No
Enumeration Date:2005-07-17
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY161772207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01060631Medicaid
NY19E651Medicare ID - Type Unspecified
NYA61121Medicare UPIN