Healthcare Provider Details

I. General information

NPI: 1336426246
Provider Name (Legal Business Name): BERNADETTE SAINT HILAIRE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2011
Last Update Date: 11/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 MADISON ST
ELMONT NY
11003-1308
US

IV. Provider business mailing address

1416 MADISON ST
ELMONT NY
11003-1308
US

V. Phone/Fax

Practice location:
  • Phone: 516-616-5449
  • Fax: 516-616-5449
Mailing address:
  • Phone: 516-616-5449
  • Fax: 516-616-5449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF305832-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: