Provider Demographics
NPI:1134433840
Name:MAXIM OF NEW YORK, LLC
Entity type:Organization
Organization Name:MAXIM OF NEW YORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIANNACCINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-910-1381
Mailing Address - Street 1:7227 LEE DEFOREST DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3236
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7227 LEE DEFOREST DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3236
Practice Address - Country:US
Practice Address - Phone:410-910-1381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAXIM HEALTHCARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health