Provider Demographics
NPI:1518338649
Name:LOUIS, CAMILLE
Entity Type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:
Last Name:LOUIS
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 1:14839 231ST ST
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11413-4244
Mailing Address - Country:US
Mailing Address - Phone:718-740-0717
Mailing Address - Fax:
Practice Address - Street 1:14839 231ST ST
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11413-4244
Practice Address - Country:US
Practice Address - Phone:718-740-0717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator