Provider Demographics
NPI:1518197730
Name:JOHN P. MAHER DC PC
Entity Type:Organization
Organization Name:JOHN P. MAHER DC PC
Other - Org Name:MAHER CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MAHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-878-6200
Mailing Address - Street 1:1315A ROUTE 52
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-4556
Mailing Address - Country:US
Mailing Address - Phone:845-878-6200
Mailing Address - Fax:
Practice Address - Street 1:1315A ROUTE 52
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-4556
Practice Address - Country:US
Practice Address - Phone:845-878-6200
Practice Address - Fax:845-878-6207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-22
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006456-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX46951Medicare PIN