MEDICARE: MARIE JEAN BAPTISTE LPN

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	164W00000X	Licensed Practical Nurse	230551	NY

General Provider Information

NPI Number	:	1851544118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE JEAN BAPTISTE LPN

Provider Business Mailing Address
First Line	:	1215 NEWKIRK AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-1505
Country	:	US
Telephone Number	:	516-902-4515
Fax Number	:

Provider Business Practice Location Address
First Line	:	1215 NEWKIRK AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-1505
Country	:	US
Telephone Number	:	516-902-4515
Fax Number	:

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

Provider Enumeration Date	:	10/30/2008
Last Update Date	:	10/30/2008

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