Individual
MRS. MODISE ELMINE-DAUTRUCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,NP
Contact information
Practice address
541 CLARKSON AVE, BROOKLYN, NY 11203
(718) 245-3480
(718) 245-5587
Mailing address
900 FRANKLIN AVE, VALLEY STREAM, NY 11580-2145
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
543061-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
31176801
NY
Other
Enumeration date
08/08/2023
Last updated
08/13/2025
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