Provider Demographics
NPI:1598965204
Name:MAIMONIDES MEDICAL CENTER- DIVISION OF HEAD / NECK SURGERY FPP
Entity Type:Organization
Organization Name:MAIMONIDES MEDICAL CENTER- DIVISION OF HEAD / NECK SURGERY FPP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-283-8793
Mailing Address - Street 1:GPO BOX 27399
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087
Mailing Address - Country:US
Mailing Address - Phone:718-283-8793
Mailing Address - Fax:718-283-8713
Practice Address - Street 1:4802 10TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2916
Practice Address - Country:US
Practice Address - Phone:718-283-8793
Practice Address - Fax:718-283-8713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233702208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty