Basic Information
| Provider Information | |||||||||
| NPI: | 1952584773 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRAHAM-WILLOUGHBY | ||||||||
| FirstName: | MAXINE | ||||||||
| MiddleName: | HILARY | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 FANNING MILL RD | ||||||||
| Address2: | WYNDHAM FARMS | ||||||||
| City: | STEWARTSVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088863224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9088594844 | ||||||||
| FaxNumber: | 9088598255 | ||||||||
| Practice Location | |||||||||
| Address1: | 151 KNOLLCROFT RD | ||||||||
| Address2: | |||||||||
| City: | LYONS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079395001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9086470180 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2007 | ||||||||
| LastUpdateDate: | 12/14/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0600X | 26NR09523600 | NJ | Y | Nursing Service Providers | Registered Nurse | Gerontology |
No ID Information.