Provider Demographics
NPI:1104093236
Name:MAFFEI, ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:MAFFEI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:95 GRASSLANDS RD
Mailing Address - Street 2:NYMC DEPT SURGERY
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1652
Mailing Address - Country:US
Mailing Address - Phone:914-493-7621
Mailing Address - Fax:914-594-4359
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:SUITE 1700
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-493-2853
Practice Address - Fax:914-347-4401
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2008-11-18
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Provider Licenses
StateLicense IDTaxonomies
NY244357-1208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400003992Medicare PIN