Provider Demographics
NPI:1942415385
Name:LOISEAN, MARIE CARMEL
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:CARMEL
Last Name:LOISEAN
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 1:866 EDWARDS BLD
Mailing Address - Street 2:
Mailing Address - City:N VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580
Mailing Address - Country:US
Mailing Address - Phone:516-837-9659
Mailing Address - Fax:
Practice Address - Street 1:580 GEORGIA ST
Practice Address - Street 2:
Practice Address - City:S HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550
Practice Address - Country:US
Practice Address - Phone:516-833-7170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192 149 1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse