Provider Demographics
NPI:1922447465
Name:MAIDHOF, WILLIAM (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:MAIDHOF
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 UTOPIA PKWY
Mailing Address - Street 2:ST. ALBERT HALL ROOM 114
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11439-9000
Mailing Address - Country:US
Mailing Address - Phone:718-990-5275
Mailing Address - Fax:718-990-1986
Practice Address - Street 1:8000 UTOPIA PKWY
Practice Address - Street 2:ST. ALBERT HALL ROOM 114
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11439-9000
Practice Address - Country:US
Practice Address - Phone:718-990-5275
Practice Address - Fax:718-990-1986
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046872183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist