Provider Demographics
NPI:1235791369
Name:PAQUET, MARY EILEEN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:EILEEN
Last Name:PAQUET
Suffix:
Gender:F
Credentials:FNP
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Mailing Address - Street 1:1 BUSHWICK RD STE C
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-3839
Mailing Address - Country:US
Mailing Address - Phone:845-579-3435
Mailing Address - Fax:845-243-2100
Practice Address - Street 1:1 BUSHWICK RD STE C
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-3839
Practice Address - Country:US
Practice Address - Phone:845-579-3435
Practice Address - Fax:845-243-2100
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY344616363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily