Provider Demographics
NPI:1740423110
Name:PHILOGENE, YVROSE
Entity Type:Individual
Prefix:
First Name:YVROSE
Middle Name:
Last Name:PHILOGENE
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 1:51 HEATHCOTE RD
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-1402
Mailing Address - Country:US
Mailing Address - Phone:347-537-7174
Mailing Address - Fax:
Practice Address - Street 1:51 HEATHCOTE RD
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-1402
Practice Address - Country:US
Practice Address - Phone:347-537-7174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY569934163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse