Provider Demographics
NPI:1336934264
Name:NAEGELIN, MAIZIE GAO II
Entity type:Individual
Prefix:MS
First Name:MAIZIE
Middle Name:GAO
Last Name:NAEGELIN
Suffix:II
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 CRYSTAL LAKE DR
Mailing Address - Street 2:
Mailing Address - City:CARVER
Mailing Address - State:MA
Mailing Address - Zip Code:02330-2009
Mailing Address - Country:US
Mailing Address - Phone:781-901-1001
Mailing Address - Fax:781-901-1001
Practice Address - Street 1:300 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2806
Practice Address - Country:US
Practice Address - Phone:508-478-0207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist