Provider Demographics
NPI:1518543099
Name:VERMEILLE, MARIE JOSETTE
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:JOSETTE
Last Name:VERMEILLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:JOSETTE
Other - Last Name:PIERRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:190 COZINE AVE APT 4J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-8828
Mailing Address - Country:US
Mailing Address - Phone:646-279-3281
Mailing Address - Fax:
Practice Address - Street 1:89 BARTLETT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-4463
Practice Address - Country:US
Practice Address - Phone:718-828-2666
Practice Address - Fax:718-782-1538
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4509761163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice