Individual
DR. JEFFREY DAVID MAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6511 SPRING BROOK AVE, RHINEBECK, NY 12572-3709
(845) 876-3001
Mailing address
1351 ROUTE 55, SUITE 200, LAGRANGEVILLE, NY 12540-5108
(845) 475-9661
(845) 475-9938
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
261136
NY
208M00000X
Hospitalist Physician
Primary
261136
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04536710
—
NY
Enumeration date
06/03/2009
Last updated
01/24/2017
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