Provider Demographics
NPI:1922484542
Name:MERIZIER, GAELLE (LPN)
Entity Type:Individual
Prefix:
First Name:GAELLE
Middle Name:
Last Name:MERIZIER
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 1:1493 REMSEN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4907
Mailing Address - Country:US
Mailing Address - Phone:917-213-1347
Mailing Address - Fax:718-763-4670
Practice Address - Street 1:1493 REMSEN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4907
Practice Address - Country:US
Practice Address - Phone:917-213-1347
Practice Address - Fax:718-763-4670
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305170164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse