Provider Demographics
NPI:1841611399
Name:CERVONE, JOSIANE MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:JOSIANE
Middle Name:MARIE
Last Name:CERVONE
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 1:36 LODGE LN
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3302
Mailing Address - Country:US
Mailing Address - Phone:631-473-5189
Mailing Address - Fax:
Practice Address - Street 1:36 LODGE LN
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3302
Practice Address - Country:US
Practice Address - Phone:631-473-5189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-01
Last Update Date:2014-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY673901-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse