| Maverick Family Health | |
|
4080 State Route 28 Ste 1 Boiceville NY 12412-5129 | |
| (845) 657-7820 | |
| (845) 657-6016 |
| Full Name | Maverick Family Health |
|---|---|
| Speciality | Family Medicine |
| Location | 4080 State Route 28 Ste 1, Boiceville, New York |
| Authorized Official Name and Position | Martin David Krakower (VICE PRESIDENT) |
| Authorized Official Contact | 8456577820 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maverick Family Health 4080 State Route 28 Ste 1 Boiceville NY 12412-5129 Ph: (845) 657-7820 | Maverick Family Health 4080 State Route 28 Ste 1 Boiceville NY 12412-5129 Ph: (845) 657-7820 |
| NPI Number | 1851665947 |
|---|---|
| Provider Enumeration Date | 03/07/2012 |
| Last Update Date | 03/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851665947 | NPI | - | NPPES |
| 01907313 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Boiceville Maverick Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4080 State Route 28, Boiceville, NY 12412 Phone: 845-657-7820 Fax: 845-657-7834 |