| Todd J. Maltese, D.o., P.c. | |
|
650 Hawkins Ave Suite 7 Ronkonkoma NY 11779-2366 | |
| (631) 737-0055 | |
| (631) 737-0076 |
| Full Name | Todd J. Maltese, D.o., P.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 650 Hawkins Ave, Ronkonkoma, New York |
| Authorized Official Name and Position | Todd J. Maltese (PHYSICIAN) |
| Authorized Official Contact | 6317370055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Todd J. Maltese, D.o., P.c. 650 Hawkins Ave Suite 7 Ronkonkoma NY 11779-2366 Ph: (631) 737-0055 | Todd J. Maltese, D.o., P.c. 650 Hawkins Ave Suite 7 Ronkonkoma NY 11779-2366 Ph: (631) 737-0055 |
| NPI Number | 1902290869 |
|---|---|
| Provider Enumeration Date | 03/27/2015 |
| Last Update Date | 03/27/2015 |
| Medicare PECOS PAC ID | 0941512750 |
|---|---|
| Medicare Enrollment ID | O20150708001479 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902290869 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 265409 (New York) | Primary |
| Provider Name | Todd J Maltese |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255521456 PECOS PAC ID: 2062736119 Enrollment ID: I20150120000286 |
| Provider Name | Laura Michelle Davids |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1356602767 PECOS PAC ID: 3870873789 Enrollment ID: I20161212001821 |
| Provider Name | Rachel Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609036870 PECOS PAC ID: 8820123136 Enrollment ID: I20180611000572 |
| Provider Name | Maryana Liedke |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386987956 PECOS PAC ID: 3274881800 Enrollment ID: I20180730002270 |
| Provider Name | Sarah Elizabeth Conway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568133064 PECOS PAC ID: 9133503949 Enrollment ID: I20220829000781 |
| Provider Name | Carinne Nicole Cardona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306554027 PECOS PAC ID: 4981074408 Enrollment ID: I20221228000244 |
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