Provider Demographics
NPI:1407986797
Name:EPSTEIN, MAXINE SUSAN (RPA-C)
Entity Type:Individual
Prefix:MRS
First Name:MAXINE
Middle Name:SUSAN
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 COUNTRY CLUB DRIVE
Mailing Address - Street 2:
Mailing Address - City:FLOWER H ILL
Mailing Address - State:NY
Mailing Address - Zip Code:11050
Mailing Address - Country:US
Mailing Address - Phone:516-365-3929
Mailing Address - Fax:
Practice Address - Street 1:1300 MORRIS PARK AVENUE
Practice Address - Street 2:BELFOR 501
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-430-3204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005828-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant