Provider Demographics
NPI:1215292123
Name:HUBER, MAUREEN
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:
Last Name:HUBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 COLONIAL LN
Mailing Address - Street 2:
Mailing Address - City:BELLPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11713-2333
Mailing Address - Country:US
Mailing Address - Phone:631-286-8970
Mailing Address - Fax:
Practice Address - Street 1:61 COLONIAL LN
Practice Address - Street 2:
Practice Address - City:BELLPORT
Practice Address - State:NY
Practice Address - Zip Code:11713-2333
Practice Address - Country:US
Practice Address - Phone:631-286-8970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist