Provider Demographics
NPI:1720020449
Name:PAZ, MARIA VICTORIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA VICTORIA
Middle Name:
Last Name:PAZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:80 MARCUS DR
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4230
Mailing Address - Country:US
Mailing Address - Phone:631-391-7887
Mailing Address - Fax:631-454-4163
Practice Address - Street 1:1 BROOKDALE PLZ
Practice Address - Street 2:BROOKDALE HOSPITAL MEDICAL CENTER 12CHC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3139
Practice Address - Country:US
Practice Address - Phone:718-240-6089
Practice Address - Fax:718-240-5701
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2010-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1404502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00576756Medicaid
NY36A75Medicare ID - Type Unspecified
NY08F631Medicare ID - Type Unspecified
NY00576756Medicaid