Healthcare Provider Details

I. General information

NPI: 1437356334
Provider Name (Legal Business Name): MARIE ROSETTE PIERRE-LOUIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIE ROSETTE CYRIAC MD

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17810 WEXFORD TER
JAMAICA NY
11432
US

IV. Provider business mailing address

8900 VAN WYCK EXPY
JAMAICA NY
11418-2832
US

V. Phone/Fax

Practice location:
  • Phone: 718-658-1123
  • Fax: 718-658-7091
Mailing address:
  • Phone: 718-206-7001
  • Fax: 718-206-7005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberNY248612
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: