Individual
MS. CHELISE LOUISE LEGISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23218 MERRICK BLVD, LAURELTON, NY 11413-2115
(718) 528-3432
Mailing address
23218 MERRICK BLVD, LAURELTON, NY 11413-2115
(718) 528-3432
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4523881
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010556898
—
NY
Enumeration date
10/21/2008
Last updated
10/21/2008
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