Provider Demographics
NPI:1609298793
Name:GAITAN, MARIA A (MSED)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:A
Last Name:GAITAN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5530 98TH PL
Mailing Address - Street 2:APT LB
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-3001
Mailing Address - Country:US
Mailing Address - Phone:347-131-2749
Mailing Address - Fax:
Practice Address - Street 1:5530 98TH PL
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-3001
Practice Address - Country:US
Practice Address - Phone:718-271-3687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-09
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator