Provider Demographics
NPI:1780016451
Name:EDOUARD, MARIE CARMEL (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:CARMEL
Last Name:EDOUARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:694 CAMPUS ST
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-2907
Mailing Address - Country:US
Mailing Address - Phone:347-737-0029
Mailing Address - Fax:
Practice Address - Street 1:694 CAMPUS ST
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-2907
Practice Address - Country:US
Practice Address - Phone:347-737-0029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275441164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse