Provider Demographics
NPI:1316205420
Name:MAAS, AMELIA LISA (MB BS)
Entity Type:Individual
Prefix:DR
First Name:AMELIA
Middle Name:LISA
Last Name:MAAS
Suffix:
Gender:F
Credentials:MB BS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10 HELLBROOK LN
Mailing Address - Street 2:
Mailing Address - City:ULSTER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12487-5209
Mailing Address - Country:US
Mailing Address - Phone:845-384-8145
Mailing Address - Fax:
Practice Address - Street 1:1001 BROADWAY STE 223
Practice Address - Street 2:
Practice Address - City:ESOPUS
Practice Address - State:NY
Practice Address - Zip Code:12429-2500
Practice Address - Country:US
Practice Address - Phone:453-848-8040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY281316207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine