Provider Demographics
NPI:1700092764
Name:PRETER, MAURICE (MD)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:
Last Name:PRETER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 5TH AVE
Mailing Address - Street 2:112
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6928
Mailing Address - Country:US
Mailing Address - Phone:212-713-5336
Mailing Address - Fax:212-713-5336
Practice Address - Street 1:1160 5TH AVE
Practice Address - Street 2:112
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6928
Practice Address - Country:US
Practice Address - Phone:212-713-5336
Practice Address - Fax:212-713-5336
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2283622084N0400X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry