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Individual

MR. JUAN E MAGUINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1779 RICHMOND AVE, STATEN ISLAND, NY 10314-3907
(718) 982-6800
(718) 982-6830
Mailing address
1779 RICHMOND AVE, STATEN ISLAND, NY 10314-3907
(718) 982-6800
(718) 982-6830

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
219130
NY
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
219130
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02227943
NY
05
03120101
NY
Enumeration date
12/15/2005
Last updated
12/27/2018
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