Provider Demographics
NPI:1942647748
Name:JEAN LOUIS, YVES MOLIERE (NMD; MPH)
Entity Type:Individual
Prefix:DR
First Name:YVES MOLIERE
Middle Name:
Last Name:JEAN LOUIS
Suffix:
Gender:M
Credentials:NMD; MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13935 228TH ST
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2946
Mailing Address - Country:US
Mailing Address - Phone:646-474-6230
Mailing Address - Fax:
Practice Address - Street 1:13535 228TH ST
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-2444
Practice Address - Country:US
Practice Address - Phone:646-474-6230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0095845175F00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No175F00000XOther Service ProvidersNaturopath