Healthcare Provider Details

I. General information

NPI: 1245155738
Provider Name (Legal Business Name): GUIRLAINE THERVIL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2383 ELBERT AVE
NORTH BELLMORE NY
11710-3033
US

IV. Provider business mailing address

2383 ELBERT AVE
NORTH BELLMORE NY
11710-3033
US

V. Phone/Fax

Practice location:
  • Phone: 786-873-7002
  • Fax:
Mailing address:
  • Phone: 786-873-7002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number287551-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: