MEDICARE: MARTINE DUROSEAU

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
1	374U00000X	Home Health Aide	1432L001	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871268243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTINE DUROSEAU

Provider Business Mailing Address
First Line	:	3018 GLENWOOD RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2642
Country	:	US
Telephone Number	:	718-856-6800
Fax Number	:	718-856-6878

Provider Business Practice Location Address
First Line	:	3018 GLENWOOD RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2642
Country	:	US
Telephone Number	:	718-856-6800
Fax Number	:	718-856-6878

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2021
Last Update Date	:	08/09/2021

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Directions to “ MARTINE DUROSEAU ” Practice Location

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