MEDICARE: MISS MARILYN LAURENT RN

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	163W00000X	Registered Nurse	908237-01	NY
2	164W00000X	Licensed Practical Nurse	310302-1	NY

General Provider Information

NPI Number	:	1629332929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MARILYN LAURENT RN

Provider Business Mailing Address
First Line	:	164 LINDEN BLVD APT C12
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-3650
Country	:	US
Telephone Number	:	347-348-9904
Fax Number	:

Provider Business Practice Location Address
First Line	:	164 LINDEN BLVD
Second Line	:	APT. C12
City	:	BROOKLYN
State	:	NY
Zip	:	11226-3642
Country	:	US
Telephone Number	:	347-348-9904
Fax Number	:

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

Provider Enumeration Date	:	07/02/2012
Last Update Date	:	04/01/2026

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