Healthcare Provider Details

I. General information

NPI: 1134031313
Provider Name (Legal Business Name): MARIE FRANTZ PARDIEU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

637 DOVER RD
OCEANSIDE NY
11572-1008
US

IV. Provider business mailing address

637 DOVER RD
OCEANSIDE NY
11572-1008
US

V. Phone/Fax

Practice location:
  • Phone: 646-431-4931
  • Fax:
Mailing address:
  • Phone: 646-431-4931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number736234
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number736234
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: