Individual
JESSIE MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2488 GRAND CONCOURSE RM 417, BRONX, NY 10458-5206
(718) 584-7204
Mailing address
2488 GRAND CONCOURSE RM 417, BRONX, NY 10458-5206
(718) 584-7204
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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