Individual
LUIS V MALDONADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
42 FLEETWOOD RD, COMMACK, NY 11725-1760
(631) 209-9430
Mailing address
1100 SHAMES DR, SUITE 100, WESTBURY, NY 11590-1765
(516) 693-0700
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
199111-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01592209
—
NY
Enumeration date
07/06/2006
Last updated
04/07/2015
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