Individual
MARIE JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
79 MIDDLEVILLE RD, BUILDING 92, NURSING HOME 2, NORTHPORT, NY 11768-2200
(631) 261-4400
Mailing address
79, MIDDLEVILLE ROAD NVAMC, BUILDING 92, NURSING HOME 2, NORTHPORT, NY 11768
(631) 261-4400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F305535
NY
Other
Enumeration date
11/26/2014
Last updated
11/26/2014
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