=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033585336
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIE AUSTIN-SAINTELUS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2015
-----------------------------------------------------
Last Update Date | 08/20/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 149 GORDON AVE
-----------------------------------------------------
City | WEST BABYLON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11704-2300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-266-8055
-----------------------------------------------------
Fax | 631-920-2616
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 149 GORDON AVE
-----------------------------------------------------
City | WEST BABYLON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11704-2300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-266-8055
-----------------------------------------------------
Fax | 631-920-2616
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number | 317448
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------