Provider Demographics
NPI:1497192538
Name:LEGERME, CLAIRE (MSED)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:LEGERME
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 SCHENECTADY AVE APT F16
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-1360
Mailing Address - Country:US
Mailing Address - Phone:718-690-8909
Mailing Address - Fax:
Practice Address - Street 1:457 SCHENECTADY AVE APT # F16
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-690-8909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY664841174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator