Provider Demographics
NPI:1295064095
Name:MAIMONIDES MEDICAL CENTER
Entity type:Organization
Organization Name:MAIMONIDES MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE CHAIRMEN DEPARTMENT PEDIATRICS
Authorized Official - Prefix:DR
Authorized Official - First Name:LUDOVICO
Authorized Official - Middle Name:
Authorized Official - Last Name:GUARINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-283-6652
Mailing Address - Street 1:4802 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-2916
Mailing Address - Country:US
Mailing Address - Phone:718-765-2677
Mailing Address - Fax:718-765-2676
Practice Address - Street 1:6300 8TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4718
Practice Address - Country:US
Practice Address - Phone:718-765-2677
Practice Address - Fax:718-765-2676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336097-1261QI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy