Provider Demographics
NPI:1528179694
Name:MAZE HEALTH
Entity Type:Organization
Organization Name:MAZE HEALTH
Other - Org Name:MAZE LABORATORIES THE MEDICAL CENTER FOR FEMALE SEXUALITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:WERNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-997-4100
Mailing Address - Street 1:2975 WESTCHESTER AVENUE STE G03
Mailing Address - Street 2:
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577
Mailing Address - Country:US
Mailing Address - Phone:914-997-4100
Mailing Address - Fax:914-683-0974
Practice Address - Street 1:2975 WESTCHESTER AVENUE STE G03
Practice Address - Street 2:
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577
Practice Address - Country:US
Practice Address - Phone:914-997-4100
Practice Address - Fax:914-683-0974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173066208800000X
CT033744208800000X
NJ61153208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F83939Medicare UPIN