Provider Demographics
NPI:1215281027
Name:MAXEY, DAVID ADRIAN MCCOMBS (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID ADRIAN
Middle Name:MCCOMBS
Last Name:MAXEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 MAPLE ST
Mailing Address - Street 2:APT. 2
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-2214
Mailing Address - Country:US
Mailing Address - Phone:609-356-3287
Mailing Address - Fax:
Practice Address - Street 1:168 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07114-3721
Practice Address - Country:US
Practice Address - Phone:973-465-0068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019284103TC0700X
NJ35SI00492200103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical