Provider Demographics
NPI:1396092607
Name:MASLAUSKAS-KING, ANNMARIE
Entity type:Individual
Prefix:MS
First Name:ANNMARIE
Middle Name:
Last Name:MASLAUSKAS-KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 JONES AVE
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3818
Mailing Address - Country:US
Mailing Address - Phone:516-524-6273
Mailing Address - Fax:
Practice Address - Street 1:2050 JONES AVE
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-3818
Practice Address - Country:US
Practice Address - Phone:516-524-6273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY606320951252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency