Provider Demographics
NPI:1083057897
Name:TOUSSAINT, MAXIME JUNIOR (RN, NP)
Entity Type:Individual
Prefix:MR
First Name:MAXIME
Middle Name:JUNIOR
Last Name:TOUSSAINT
Suffix:
Gender:M
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:GARNERVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10923-1906
Mailing Address - Country:US
Mailing Address - Phone:914-672-7505
Mailing Address - Fax:
Practice Address - Street 1:43 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-1818
Practice Address - Country:US
Practice Address - Phone:914-672-7505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY667448-1163W00000X
NY343891363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse