Individual
JEANNINE MAYTAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM
Contact information
Practice address
7 CHARLESTON CT, CORAM, NY 11727-1606
(646) 251-5489
Mailing address
7 CHARLESTON CT, CORAM, NY 11727-1606
(646) 251-5489
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
001756
NY
Other
Enumeration date
04/10/2017
Last updated
04/10/2017
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