Maxwell 21 Medical, PC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

Legal business name

MAXWELL 21 MEDICAL, PC

Practice address

111 Broadway RM 503
New York, NY 10006-1981

Phone

(212) 952-9355

NPI assigned

Jun 3, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Thania Louisor

Title

Insurance

Phone

(212) 952-9355

Specialties & licenses 4

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433289600000",
    "number": "1205216322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BROADWAY RM 503",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061981",
            "telephone_number": "212-952-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BROADWAY RM 503",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061981",
            "telephone_number": "212-952-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXWELL 21 MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-03",
        "last_updated": "2015-06-03",
        "status": "A",
        "authorized_official_last_name": "LOUISOR",
        "authorized_official_first_name": "THANIA",
        "authorized_official_title_or_position": "INSURANCE",
        "authorized_official_telephone_number": "212-952-9355",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Physical Medicine & Rehabilitation) Physician in New York, NY
• Providers in New York, NY by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.