Provider Demographics
NPI:1619415676
Name:MAASER CD PAP, INC.
Entity Type:Organization
Organization Name:MAASER CD PAP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VIOLETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVSHIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-427-5265
Mailing Address - Street 1:180 WEST END AVENUE
Mailing Address - Street 2:APT. 15G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:718-427-5265
Mailing Address - Fax:
Practice Address - Street 1:1117 BRIGHTON BEACH AVE FL 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5558
Practice Address - Country:US
Practice Address - Phone:718-427-5265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04709922Medicaid