Provider Demographics
NPI:1801577903
Name:MADDREY, NATALIE MICHELLE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:MICHELLE
Last Name:MADDREY
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 1:1943 FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-2311
Mailing Address - Country:US
Mailing Address - Phone:718-704-8500
Mailing Address - Fax:
Practice Address - Street 1:112 W 27TH ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6241
Practice Address - Country:US
Practice Address - Phone:914-257-3732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist