Active NPI
Karen A Maybank, MD
- Pediatrics Physician
- Hauppauge, NY
National Provider Identifier
1104827773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 228477
- Practice address
- 225 Rabro Dr
Office of Minority Health
Hauppauge, NY 11788-4241 - Phone
- (631) 853-5078
- NPI assigned
- Aug 9, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 228477 | NY | Primary |
| Public Health & General Preventive Medicine Physician | 2083P0901X | 228477 | NY |
Addresses
Primary practice location
225 Rabro Dr
Office of Minority Health
Hauppauge, NY 11788-4241
Mailing address
225 Rabro Dr
Office of Minority Health
Hauppauge, NY 11788-4241
Phone (631) 853-5078
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02601114 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 228477 | NY | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191456000000",
"number": "1104827773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 RABRO DR",
"address_2": "OFFICE OF MINORITY HEALTH",
"city": "HAUPPAUGE",
"state": "NY",
"postal_code": "117884241",
"telephone_number": "631-853-5078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 RABRO DR",
"address_2": "OFFICE OF MINORITY HEALTH",
"city": "HAUPPAUGE",
"state": "NY",
"postal_code": "117884241",
"telephone_number": "631-853-5078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYBANK",
"first_name": "KAREN",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-08-09",
"last_updated": "2007-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "228477",
"primary": true
},
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "NY",
"license": "228477",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02601114",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hauppauge, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.