Provider Demographics
NPI:1093968992
Name:MARIUS DUBOIS, MARIE YANICK (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:YANICK
Last Name:MARIUS DUBOIS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 E MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722-3130
Mailing Address - Country:US
Mailing Address - Phone:631-256-6500
Mailing Address - Fax:
Practice Address - Street 1:44 E MAPLE ST
Practice Address - Street 2:
Practice Address - City:CENTRAL ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11722-3130
Practice Address - Country:US
Practice Address - Phone:631-256-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY413435-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse