1003315102 NPI number — MADELINE MALDONADO, LCSW CONSULTING P.C.

Table of content: DR. WILLIAM J. MEEGAN PH.D. (NPI 1306916044)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003315102 NPI number — MADELINE MALDONADO, LCSW CONSULTING P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MADELINE MALDONADO, LCSW CONSULTING P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003315102
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1160 MIDLAND AVENUE
Provider Second Line Business Mailing Address:
APT 10G
Provider Business Mailing Address City Name:
BRONXVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10708-6428
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-880-8193
Provider Business Mailing Address Fax Number:
914-346-5031

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1160 MIDLAND AVENUE
Provider Second Line Business Practice Location Address:
APT 10G
Provider Business Practice Location Address City Name:
BRONXVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10708-6428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-880-8193
Provider Business Practice Location Address Fax Number:
914-346-5031
Provider Enumeration Date:
02/05/2018

Additional Information

Authorized Official

Authorized Official Last Name:
MALDONADO
Authorized Official First Name:
MADELINE
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINICAL SOCIAL WORKER
Authorized Official Telephone Number:
917-880-8193

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  R062204-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: R062204-1 . This is a "LICENSE NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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