Provider Demographics
NPI:1649401803
Name:REID, MARIE E (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:E
Last Name:REID
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1795 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3544
Mailing Address - Country:US
Mailing Address - Phone:516-868-8425
Mailing Address - Fax:
Practice Address - Street 1:1795 SMITH ST
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3544
Practice Address - Country:US
Practice Address - Phone:516-868-8425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY565178163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse