Provider Demographics
NPI:1205681129
Name:MILLS, MAXIME (MD)
Entity type:Individual
Prefix:
First Name:MAXIME
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MAXIME
Other - Middle Name:
Other - Last Name:DEBRA-SAPONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:760 BROADWAY, WOODHULL HOSPITAL
Mailing Address - Street 2:PEDIATRIC ADMINISTRATION
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206
Mailing Address - Country:US
Mailing Address - Phone:718-963-8779
Mailing Address - Fax:718-963-7957
Practice Address - Street 1:760 BROADWAY, WOODHULL HOSPITAL
Practice Address - Street 2:PEDIATRIC ADMINISTRATION
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-963-8779
Practice Address - Fax:718-963-7957
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-23
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty