Provider Demographics
NPI:1437238581
Name:MAHER, JOHN THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:THOMAS
Last Name:MAHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 4TH AVE # LEVELC
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2787
Mailing Address - Country:US
Mailing Address - Phone:718-852-5810
Mailing Address - Fax:718-802-1223
Practice Address - Street 1:110 4TH AVE # LEVELC
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-2787
Practice Address - Country:US
Practice Address - Phone:712-238-4535
Practice Address - Fax:718-921-3448
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184820207V00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01511953Medicaid
NY01511953Medicaid
NYF55055Medicare UPIN