Provider Demographics
NPI:1689996381
Name:DESCORBETH, YVES (LPN)
Entity Type:Individual
Prefix:
First Name:YVES
Middle Name:
Last Name:DESCORBETH
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:YVES
Other - Middle Name:
Other - Last Name:DESCORBETH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:15 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1126
Mailing Address - Country:US
Mailing Address - Phone:516-708-1953
Mailing Address - Fax:
Practice Address - Street 1:15 CHURCH ST
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-1126
Practice Address - Country:US
Practice Address - Phone:516-708-1953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238051164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY238051OtherNYS NURSING LICENSE LPN