Organization
MAXIM KREDITOR MD PC
Active
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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