Provider Demographics
NPI:1326178070
Name:ANIS, SOEURETTE (RN)
Entity Type:Individual
Prefix:
First Name:SOEURETTE
Middle Name:
Last Name:ANIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SOEURETTE
Other - Middle Name:
Other - Last Name:JEAN-GILLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 724
Mailing Address - Street 2:
Mailing Address - City:HAVERSTRAW
Mailing Address - State:NY
Mailing Address - Zip Code:10927-0724
Mailing Address - Country:US
Mailing Address - Phone:914-332-8938
Mailing Address - Fax:914-332-8023
Practice Address - Street 1:220 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-5837
Practice Address - Country:US
Practice Address - Phone:914-332-8938
Practice Address - Fax:914-332-8023
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY502385163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse