Provider Demographics
NPI:1518374073
Name:VOLCY-REGISTRE, MARIE STAELLE I (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:STAELLE
Last Name:VOLCY-REGISTRE
Suffix:I
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 ROQUETTE AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-1209
Mailing Address - Country:US
Mailing Address - Phone:347-961-5238
Mailing Address - Fax:
Practice Address - Street 1:166 ROQUETTE AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-1209
Practice Address - Country:US
Practice Address - Phone:347-961-5238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY409931-1163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care