Provider Demographics
NPI:1578844593
Name:MAAYAN, SHLOMO (MD)
Entity Type:Individual
Prefix:DR
First Name:SHLOMO
Middle Name:
Last Name:MAAYAN
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 1:888 MAIN ST
Mailing Address - Street 2:12-15
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10044-0213
Mailing Address - Country:US
Mailing Address - Phone:914-413-8738
Mailing Address - Fax:
Practice Address - Street 1:888 MAIN ST
Practice Address - Street 2:12-15
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10044-0213
Practice Address - Country:US
Practice Address - Phone:914-413-8738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-03
Last Update Date:2011-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1420461207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine