Individual
PAUL MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
F.N.P.
Contact information
Practice address
1425 PORTLAND AVE # 298, ROCHESTER, NY 14621-3011
(585) 922-4026
(585) 922-4790
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-4026
(585) 922-4790
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
333043
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02388205
—
NY
Enumeration date
07/17/2006
Last updated
07/13/2021
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