Individual
EMMANISE LOUIS I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
15 E MAIN ST STE 1, PORT JERVIS, NY 12771-1924
(845) 893-9463
(845) 767-5113
Mailing address
88 COUTANT RD, CIRCLEVILLE, NY 10919-3208
(718) 926-1264
(845) 288-5510
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F332918-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02915864
—
NY
Enumeration date
02/13/2007
Last updated
12/17/2025
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