Healthcare Provider Details

I. General information

NPI: 1346425428
Provider Name (Legal Business Name): MARIE GELUMAIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIE GELUMAIS JEAN PIERRE

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4123 AVENUE D
BROOKLYN NY
11203
US

IV. Provider business mailing address

2100 MILBURN AVE
BALDWIN NY
11510
US

V. Phone/Fax

Practice location:
  • Phone: 718-625-2275
  • Fax:
Mailing address:
  • Phone: 516-546-2464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number037771
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: