Organization
MAXWELL 21 MEDICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS THANIA LOUISOR (INSURANCE)
(212) 952-9355
Entity
Organization
Contact information
Practice address
111 BROADWAY RM 503, NEW YORK, NY 10006-1981
(212) 952-9355
Mailing address
111 BROADWAY RM 503, NEW YORK, NY 10006-1981
(212) 952-9355
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
171100000X
Acupuncturist
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
06/03/2015
Last updated
06/03/2015
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