Provider Demographics
NPI:1538585856
Name:MAXIMEL, NADIRA NEESHA (RN)
Entity type:Individual
Prefix:MRS
First Name:NADIRA
Middle Name:NEESHA
Last Name:MAXIMEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1952 1ST AVE
Mailing Address - Street 2:APT 10G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6411
Mailing Address - Country:US
Mailing Address - Phone:646-256-7548
Mailing Address - Fax:
Practice Address - Street 1:1952 1ST AVE
Practice Address - Street 2:APT 10G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6411
Practice Address - Country:US
Practice Address - Phone:646-256-7548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317741164W00000X
NY7308301163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse