Provider Demographics
NPI:1861722050
Name:MAPLE NP ADULT HEALTH CARE PLLC
Entity type:Organization
Organization Name:MAPLE NP ADULT HEALTH CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSEILLE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:845-517-5252
Mailing Address - Street 1:22 S MADISON AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5527
Mailing Address - Country:US
Mailing Address - Phone:845-517-5252
Mailing Address - Fax:845-517-5253
Practice Address - Street 1:22 S MADISON AVE STE C
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5527
Practice Address - Country:US
Practice Address - Phone:845-517-5252
Practice Address - Fax:845-517-5253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty