Individual
DR. WAYNE MABEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
71 PROSPECT AVE, SUITE 190, HUDSON, NY 12534-2907
(518) 697-3000
(518) 697-3015
Mailing address
PO BOX 2000, HUDSON, NY 12534-2000
(518) 828-8363
(518) 697-3388
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
162127
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00969228
—
NY
Enumeration date
05/18/2006
Last updated
07/16/2007
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