Healthcare Provider Details

I. General information

NPI: 1497689624
Provider Name (Legal Business Name): MS. MYRLANDE PIERRE-LYS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 SCHENECTADY AVE FL 3
BROOKLYN NY
11213-2330
US

IV. Provider business mailing address

10300 SHORE FRONT PKWY APT 7K
ROCKAWAY PARK NY
11694-2773
US

V. Phone/Fax

Practice location:
  • Phone: 347-915-1112
  • Fax: 347-915-1113
Mailing address:
  • Phone: 347-915-1112
  • Fax: 347-915-1113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: