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Organization

MARJORIE LOUIS-JACQUES NP FAMILY HEALTH PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARJORIE LOUIS-JACQUES NP (AUTHORIZED OFFICIAL)
(732) 239-0115
Entity
Organization

Contact information

Practice address
6144 ROUTE 25A STE 18B, WADING RIVER, NY 11792-2018
(732) 239-0155
Mailing address
6144 ROUTE 25A STE 18B, WADING RIVER, NY 11792-2018

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
339159
LICENSE
NY
Enumeration date
06/02/2022
Last updated
06/02/2022
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