Individual
JOHN K MAESAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 OLD COUNTRY RD, SUITE 135, MINEOLA, NY 11501-4235
(516) 663-2169
(516) 663-2179
Mailing address
200 OLD COUNTRY RD, SUITE 135, MINEOLA, NY 11501-4235
(516) 663-2169
(516) 663-2179
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
100559
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00928978
—
NY
01
—
10491029
CAQH
NY
Enumeration date
04/14/2006
Last updated
03/07/2023
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