Jean Derissaint LPN

NPI 1063712263 - Licensed Practical Nurse - 164W00000X

NPI Details
NPI 1063712263
Gender Male
Enumeration Date 10/22/2010
Last Updated 04/07/2011
Entity Type Individual
Active Over 6 years ago
Practice Location
697 E 39TH ST
PH
BROOKLYN NY, 11203-5615, US
Phone (718) 664-5793
Fax
Business Location
697 E 39TH ST
PH
BROOKLYN NY, 11203-5615, US
Phone (718) 664-5793
Fax
Toxanomy
Taxonomy Code 164W00000X
License State New York
License Number 302111-1
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According to our database, Mr. Jean Derissaint LPN NPI is 1063712263, taxonomy code is 164W00000X and license number is 302111-1, license state is located at New York. Jean Derissaint LPN physically located at 697 E 39th St, Brooklyn NY, 11203-5615. NPI Number Jean Derissaint LPN has the Individual type.

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1063712263 NPI number is provided on an as is basis without warranty of any kind. 1063712263 is maintained by the National Plan & Provider Enumeration System. The contents of Jean Derissaint LPN are for informational purposes only.