Maverick Family Medical, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MAVERICK FAMILY MEDICAL, PC

Practice address

4080 State Route 28 Ste 1
Boiceville, NY 12412-5129

Phone

(845) 657-7820

Fax

(845) 657-6016

NPI assigned

Mar 7, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Martin David Krakower, MDNPI 1073615738

Title

Vice President

Phone

(845) 657-7820

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Maverick Family Health Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Martin Krakower, M.D.

  • Family Medicine Physician
  • Phoenicia, NY
  • NPI 1073615738
  NPD (past) Authorized official

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1851665947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 STATE ROUTE 28 STE 1",
            "city": "BOICEVILLE",
            "state": "NY",
            "postal_code": "124125129",
            "telephone_number": "845-657-7820",
            "fax_number": "845-657-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 STATE ROUTE 28 STE 1",
            "city": "BOICEVILLE",
            "state": "NY",
            "postal_code": "124125129",
            "telephone_number": "845-657-7820",
            "fax_number": "845-657-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVERICK FAMILY MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-03-07",
        "status": "A",
        "authorized_official_last_name": "KRAKOWER",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "845-657-7820",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01907313",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maverick Family Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brianna Inzeo
• Kathryn Buncher LCSW PLLC
• Noa Halverson Kaufhold, MSW
• Ruth A Long, RN,C
• Sara Loughlin, LMHC
• Carol L McCurdy
• Colleen Patricia McDaniel, RN
• Ariel Nicole McGrath, MS. CCC-SLP
• Peter George Nekos, RPH
• Pamela Arnold Olson, SLP

• Family Medicine Physician in Boiceville, NY
• Providers in Boiceville, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.