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NPI Code Detail

MEDICARE: MRS. MARIE D THERMIDOR

MEDICARE: MRS. MARIE D THERMIDOR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1760749725
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARIE D THERMIDOR
Provider Business Mailing Address
First Line : 22004 LINDEN BLVD
Second Line :
City : CAMBRIA HEIGHTS
State : NY
Zip : 11411-1621
Country : US
Telephone Number : 718-712-3358
Fax Number : 888-352-0588
Provider Business Practice Location Address
First Line : 22004 LINDEN BLVD
Second Line :
City : CAMBRIA HEIGHTS
State : NY
Zip : 11411-1621
Country : US
Telephone Number : 718-712-3358
Fax Number : 888-352-0588
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2012
Last Update Date : 08/21/2020

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Directions to “ MRS. MARIE D THERMIDOR ” Practice Location

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