Provider Demographics
NPI:1568784015
Name:HONORAT, MARIE GHISLAINE
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:GHISLAINE
Last Name:HONORAT
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 1:1084 ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-2438
Mailing Address - Country:US
Mailing Address - Phone:646-775-0752
Mailing Address - Fax:
Practice Address - Street 1:1084 ASHLEY DR
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-2438
Practice Address - Country:US
Practice Address - Phone:646-775-0752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218169164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse