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Individual

DR. ROBERT JOSEPH MAIDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
12 MARTIN ST, SUITE 3, WELLSVILLE, NY 14895
(585) 593-1859
(585) 593-2465
Mailing address
12 MARTIN ST, SUITE 3, SUITE 3, WELLSVILLE, NY 14895
(585) 593-9815
(585) 596-4048

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
006688
NY
103T00000X
Psychologist
006688-2
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000500140001
BLUE SHIELD WESTERN NY
NY
05
00781659
NY
01
260011314
RAIL ROAD MEDICARE
NY
01
6107819
IHA
NY
Enumeration date
10/18/2006
Last updated
10/01/2019
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