Individual
MARIE ROOSEVELT MALLEBRANCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25742 145TH AVE, ROSEDALE, NY 11422-3315
(347) 754-1221
Mailing address
25742 145TH AVE, ROSEDALE, NY 11422-3315
(347) 754-1221
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
519543
NY
Other
Enumeration date
04/19/2019
Last updated
04/19/2019
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