MEDICARE: EIGHTY 8TH NP IN ADULT HEALTH P.C

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	261QM0850X	Adult Mental Health Clinic/Center
2	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1134937220
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EIGHTY 8TH NP IN ADULT HEALTH P.C

Provider Business Mailing Address
First Line	:	1214 E 88TH ST APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-4916
Country	:	US
Telephone Number	:	347-636-4005
Fax Number	:

Provider Business Practice Location Address
First Line	:	1817 FLATBUSH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4854
Country	:	US
Telephone Number	:	347-636-4005
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. MARIE GUERLINE PAUL
Credential	:	NP
Telephone Number	:	347-636-4005

Provider Enumeration Date	:	12/21/2024
Last Update Date	:	10/23/2025

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