Provider Demographics
NPI:1679848170
Name:MAROTIERE, LOURDES MONIA (BSN)
Entity Type:Individual
Prefix:MS
First Name:LOURDES
Middle Name:MONIA
Last Name:MAROTIERE
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4209 28TH ST
Mailing Address - Street 2:CN # 25
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4131
Mailing Address - Country:US
Mailing Address - Phone:347-396-4794
Mailing Address - Fax:347-396-4767
Practice Address - Street 1:4209 28TH ST
Practice Address - Street 2:CN # 25
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4131
Practice Address - Country:US
Practice Address - Phone:347-396-4794
Practice Address - Fax:347-396-4767
Is Sole Proprietor?:No
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY455770-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool