Provider Demographics
NPI:1558827873
Name:LIAMZON, MARIA CLARITA (RN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CLARITA
Last Name:LIAMZON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MAPLE TREE AVE UNIT H1
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06906-2233
Mailing Address - Country:US
Mailing Address - Phone:203-209-2265
Mailing Address - Fax:
Practice Address - Street 1:30 MAPLE TREE AVE UNIT H1
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06906-2233
Practice Address - Country:US
Practice Address - Phone:203-209-2265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTE61090163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse