Brynne Marie Maietta, LPN

Individual provider Active NPI Licensed Practical Nurse · Holmes, NY

NPI 1326388174 · NPPES record last updated Feb 15, 2013

Key facts

NPI
1326388174
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
297804 (NY)
Practice address
313 Grape Hollow Rd
Holmes, NY 12531-5420
Phone
(845) 214-3486
NPI assigned
Feb 15, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
297804NYMDDiagnostic Radiology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 297804 NY Yes

Addresses

Primary practice location

313 Grape Hollow Rd
Holmes, NY 12531-5420

Mailing address

313 Grape Hollow Rd
Holmes, NY 12531-5420
Phone (845) 214-3486

Other providers in Holmes, NY

All providers in Holmes, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.