Provider Demographics
NPI:1871521633
Name:HOUCK, MAUREEN B (NP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:B
Last Name:HOUCK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-2216
Mailing Address - Country:US
Mailing Address - Phone:516-931-5770
Mailing Address - Fax:
Practice Address - Street 1:275 HOFSTRA UNIVERSITY
Practice Address - Street 2:HEALTH AND WELLNESS CENTER REPUBLIC HALL
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11549
Practice Address - Country:US
Practice Address - Phone:516-463-6745
Practice Address - Fax:516-463-5161
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331681363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily