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NPI Code Detail

MEDICARE: MS. MARIE DURANDISSE

MEDICARE: MS. MARIE DURANDISSE
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
1164W00000XLicensed Practical Nurse2991341NY

General Provider Information

NPI Number : 1841516291
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARIE DURANDISSE
Provider Business Mailing Address
First Line : 2920 CORTELYOU RD # A
Second Line :
City : BROOKLYN
State : NY
Zip : 11226-6313
Country : US
Telephone Number : 718-287-4300
Fax Number : 718-287-4600
Provider Business Practice Location Address
First Line : 2920 CORTELYOU RD # A
Second Line :
City : BROOKLYN
State : NY
Zip : 11226-6313
Country : US
Telephone Number : 718-287-4300
Fax Number : 718-287-4600
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2010
Last Update Date : 04/09/2010

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