Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 194999 | NY |
N | 111NI0900X | Internist | 194999 | NY |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 194999 | NY |
N | 207RC0000X | Internist - Cardiovascular Disease | 194999 | NY |
NPI | 1467527903 |
---|---|
Provider Name | Dr. Mathew Shane Maurer |
First Address | New York, NY 10032-3725 |
Second Address | New York, NY 10032-3720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 23/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01947662 | (05) | NY |
G27522 | (02) | NY |