| Dr Ciana Tyiesh Hayes Maxwell, MD | |
|
5045 Route 130 Ste F, Delran, NJ 08075-9707 | |
| (856) 461-1717 | |
| Not Available |
| Full Name | Dr Ciana Tyiesh Hayes Maxwell |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 5045 Route 130 Ste F, Delran, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689836264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | MT193245 (Pennsylvania) | Secondary |
| 208000000X | Pediatrics | 25MA08975900 (New Jersey) | Primary |
| Entity Name | Stc Pediatrics Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144864547 PECOS PAC ID: 7315372323 Enrollment ID: O20200122001254 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ciana Tyiesh Hayes Maxwell, MD 2142 Harbour Dr, Palmyra, NJ 08065-1121 Ph: () - | Dr Ciana Tyiesh Hayes Maxwell, MD 5045 Route 130 Ste F, Delran, NJ 08075-9707 Ph: (856) 461-1717 |
Dr. Pascale Bastien, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 8008 Route 130 N, Suite 204, Delran, NJ 08075 Phone: 856-824-0099 Fax: 856-824-0088 | |
Dr. Michael J Foreman, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5045 Route 130, Delran, NJ 08075 Phone: 856-461-1717 Fax: 856-461-1143 | |
Dr. Marta E Santos, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3104 Bridgeboro Rd Ste C, Delran, NJ 08075 Phone: 856-461-1717 | |
Dr. Angela Duley Harrell, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5045 Route 130, Suite F, Delran, NJ 08075 Phone: 856-461-1717 Fax: 856-461-1143 |