Provider Demographics
NPI:1043506314
Name:LEMARD, MARIE ST CLAIRE (RN)
Entity Type:Individual
Prefix:MISS
First Name:MARIE
Middle Name:ST CLAIRE
Last Name:LEMARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 ENRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-2352
Mailing Address - Country:US
Mailing Address - Phone:718-219-7543
Mailing Address - Fax:
Practice Address - Street 1:2340 ENRIGHT RD
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-2352
Practice Address - Country:US
Practice Address - Phone:718-219-7543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY642089163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse