Organization
MAXIM MOBILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT F MAZZOTTA (MANAGING MEMBER)
(203) 772-2445
Entity
Organization
Contact information
Practice address
90 HAMILTON ST, NEW HAVEN, CT 06511
(203) 772-2445
(203) 772-0855
Mailing address
90 HAMILTON ST, NEW HAVEN, CT 06511
(203) 772-2445
(203) 772-0855
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12DME0621CT01
ANTHEM BCBS
CT
01
—
A600202
OXFORD
—
Enumeration date
08/05/2006
Last updated
08/22/2020
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