Provider Demographics
NPI:1053534024
Name:MAITH, DARLENE YVETTE (RN)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:YVETTE
Last Name:MAITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:753 CLASSON AVENUE
Mailing Address - Street 2:#10H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-7500
Mailing Address - Country:US
Mailing Address - Phone:718-789-9007
Mailing Address - Fax:
Practice Address - Street 1:753 CLASSON AVENUE
Practice Address - Street 2:#10H
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-7500
Practice Address - Country:US
Practice Address - Phone:718-789-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY581686163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse