MEDICARE: MS. MARIE BRUNETTE DAMIS-MOISE NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	336128	NY
2	363L00000X	Nurse Practitioner	F336128-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043593700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIE BRUNETTE DAMIS-MOISE NP

Provider Business Mailing Address
First Line	:	592 ROCKAWAY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-5539
Country	:	US
Telephone Number	:	718-345-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 PENNSYLVANIA AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11207-4707
Country	:	US
Telephone Number	:	718-345-5000
Fax Number	:	347-875-1009

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2011
Last Update Date	:	12/04/2025

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