Individual
DECIDEL MAXUME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
147 ELM ST, VALLEY STREAM, NY 11580-4913
(347) 965-1153
Mailing address
147 ELM ST, VALLEY STREAM, NY 11580-4913
(347) 965-1153
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
F406333-01
NY
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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