Individual
NATALIA MAXIMOVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11 RALPH PL, STATEN ISLAND, NY 10304-4401
(347) 377-1979
Mailing address
11 RALPH PL, STATEN ISLAND, NY 10304-4401
(718) 954-2202
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
309106
NY
Other
Enumeration date
03/11/2019
Last updated
12/30/2019
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