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Organization

MAXIM KREDITOR MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MAXIM KREDITOR M.D. (MD/OWNER)
(212) 448-9555
Entity
Organization

Contact information

Practice address
380 2ND AVENUE, SUITE 1003, NEW YORK, NY 10010
(212) 448-9555
(212) 448-0999
Mailing address
380 2ND AVE, SUITE 1003, NEW YORK, NY 10010-5615
(212) 448-9555
(212) 448-0999

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
216136
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02568638
NY
Enumeration date
08/07/2007
Last updated
08/16/2012
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