MEDICARE: MARIE PIERRE LOUIS

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	174400000X	Specialist	703416	NY

General Provider Information

NPI Number	:	1730599853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE PIERRE LOUIS

Provider Business Mailing Address
First Line	:	2477 BRIGHAM ST FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-1003
Country	:	US
Telephone Number	:	646-400-8026
Fax Number	:	718-676-1228

Provider Business Practice Location Address
First Line	:	2477 BRIGHAM ST FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-1003
Country	:	US
Telephone Number	:	646-400-8026
Fax Number	:	718-676-1228

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

Provider Enumeration Date	:	04/28/2014
Last Update Date	:	04/28/2014

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Directions to “ MARIE PIERRE LOUIS ” Practice Location

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