Individual
DR. MARY JANE MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
11 E 75TH ST, SUITE 1B, NEW YORK, NY 10021-2639
(212) 517-7342
(718) 423-3223
Mailing address
11 E 75TH ST, SUITE 1B, NEW YORK, NY 10021-2639
(212) 517-7342
(718) 423-3223
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
008011-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0067723
GROUP HEALTH INCORPORATED
NY
05
—
02033190
—
NY
01
—
147145
VALUE OPTIONS PROVIDER NO
NY
01
—
437643
AETNA
NY
01
—
6180606
UNITED HEALTHCARE PROV NO
NY
01
—
64986
CIGNA PROVIDER NUMBER
NY
01
—
DR9064
OXFORD HEALTH PLAN
NY
01
—
V50610
EMPIRE BCBS PROVIDER NO
NY
Enumeration date
10/02/2006
Last updated
07/21/2022
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