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1013561836
LARISA MAKSIMOV
JAMAICA, NY
NPI
1013561836
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: NY 564028)
Enumeration Date
2019-07-30
Last Update Date
2019-07-30
Business Address
LARISA MAKSIMOV
8235 MAIN ST
JAMAICA, NY 11435-1207
Phone number: 212-810-0700
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Mailing Address
LARISA MAKSIMOV
8235 MAIN ST
JAMAICA, NY 11435-1207
Phone number: 212-810-0700
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