Provider Demographics
NPI:1265842504
Name:POITEVIEN, CARLINE
Entity Type:Individual
Prefix:
First Name:CARLINE
Middle Name:
Last Name:POITEVIEN
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 1:246 NORFELD BLVD
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-3640
Mailing Address - Country:US
Mailing Address - Phone:516-437-9743
Mailing Address - Fax:
Practice Address - Street 1:246 NORFELD BLVD
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-3640
Practice Address - Country:US
Practice Address - Phone:516-437-9743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238231164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse