Provider Demographics
NPI:1700240785
Name:ANTWI, MAXWELL (RN)
Entity Type:Individual
Prefix:MR
First Name:MAXWELL
Middle Name:
Last Name:ANTWI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 CARPENTER AVE
Mailing Address - Street 2:APT 2J
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-3741
Mailing Address - Country:US
Mailing Address - Phone:347-207-1829
Mailing Address - Fax:
Practice Address - Street 1:3905 CARPENTER AVE
Practice Address - Street 2:APT 2J
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-3741
Practice Address - Country:US
Practice Address - Phone:347-207-1829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY699350-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse