Provider Demographics
NPI:1861461808
Name:HAO, MADDIE Y (MD-PEDIATRICS)
Entity Type:Individual
Prefix:DR
First Name:MADDIE
Middle Name:Y
Last Name:HAO
Suffix:
Gender:F
Credentials:MD-PEDIATRICS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-2428
Mailing Address - Country:US
Mailing Address - Phone:617-745-0280
Mailing Address - Fax:617-745-0288
Practice Address - Street 1:435 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-2428
Practice Address - Country:US
Practice Address - Phone:617-745-0280
Practice Address - Fax:617-745-0288
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA158402208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0118915Medicaid
MAA29862Medicare ID - Type Unspecified
MA0118915Medicaid