Healthcare Provider Details

I. General information

NPI: 1841638285
Provider Name (Legal Business Name): MARJORIE LOUISSAINT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23218 MERRICK BLVD
LAURELTON NY
11413-2115
US

IV. Provider business mailing address

P.O. BOX 30481
ELMONT NY
11003
US

V. Phone/Fax

Practice location:
  • Phone: 718-528-3432
  • Fax:
Mailing address:
  • Phone: 718-528-3432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number987741-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number299759-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: