Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 239261 | NY |
N | 207RC0000X | Internist - Cardiovascular Disease | 239261 | NY |
NPI | 1700976537 |
---|---|
Provider Name | Simon Maybaum |
First Address | Manhasset, NY 11030-3816 |
Second Address | Manhasset, NY 11030-3816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 15/08/2019 |