Provider Demographics
NPI:1073845442
Name:TOUSSAINT, MAGDALA
Entity Type:Individual
Prefix:
First Name:MAGDALA
Middle Name:
Last Name:TOUSSAINT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-4084
Mailing Address - Country:US
Mailing Address - Phone:845-356-0941
Mailing Address - Fax:
Practice Address - Street 1:254 N MAIN ST
Practice Address - Street 2:APT E22
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-4084
Practice Address - Country:US
Practice Address - Phone:845-356-0941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY266704164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse