Provider Demographics
NPI:1396352993
Name:MAEZ INTEGRATIVE HEALTHCARE, LLC
Entity type:Organization
Organization Name:MAEZ INTEGRATIVE HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:N
Authorized Official - Last Name:ONWUKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-748-4199
Mailing Address - Street 1:200 NEW RD
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1306
Mailing Address - Country:US
Mailing Address - Phone:609-748-4199
Mailing Address - Fax:609-748-4112
Practice Address - Street 1:200 NEW RD
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1306
Practice Address - Country:US
Practice Address - Phone:609-748-4199
Practice Address - Fax:609-748-4112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty