Individual
DR. NICHOLAS ALAN MAENZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
30 LIVINGSTON ST, POUGHKEEPSIE, NY 12601-4706
(845) 454-8500
Mailing address
655 ROCK CUT RD, WALDEN, NY 12586-2454
(914) 419-4556
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
320605
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
05/10/2020
Last updated
04/11/2023
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