Individual
JACQUES NAZAIRE MOMPLAISIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
777 SEAVIEW AVE, STATEN ISLAND, NY 10305-3409
(718) 667-2402
Mailing address
171 JENSEN AVE, RAHWAY, NJ 07065-2219
(732) 213-9519
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
798551
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
798551
—
NY
Enumeration date
09/21/2021
Last updated
09/21/2021
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