Provider Demographics
NPI:1033418751
Name:JOSEPH, MARIE-ANGE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:MARIE-ANGE
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 TRESSER BLVD
Mailing Address - Street 2:APT. 14A
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-3201
Mailing Address - Country:US
Mailing Address - Phone:203-276-1554
Mailing Address - Fax:
Practice Address - Street 1:300 TRESSER BLVD
Practice Address - Street 2:APT. 14A
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-3201
Practice Address - Country:US
Practice Address - Phone:203-276-1554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304419-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse