Provider Demographics
NPI:1457824211
Name:JEAN-PHARUNS, MARC (RN)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:
Last Name:JEAN-PHARUNS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-3496
Mailing Address - Country:US
Mailing Address - Phone:347-869-0732
Mailing Address - Fax:
Practice Address - Street 1:1411 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-3496
Practice Address - Country:US
Practice Address - Phone:347-869-0732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-04
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY748736-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse