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Individual

IAN B MAITIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
42 E LAUREL RD STE 1700, STRATFORD, NJ 08084-1354
(856) 566-7010
(856) 566-6956
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 566-7010
(856) 566-6956

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
25MA05556000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0014118890001
PA
Enumeration date
10/11/2005
Last updated
09/10/2025
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