Provider Demographics
NPI:1952865420
Name:JEAN-FRANCOIS, NAUSICA
Entity Type:Individual
Prefix:
First Name:NAUSICA
Middle Name:
Last Name:JEAN-FRANCOIS
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 1:177 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-4931
Mailing Address - Country:US
Mailing Address - Phone:516-395-8601
Mailing Address - Fax:
Practice Address - Street 1:2174 HEWLETT AVE STE 109
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3606
Practice Address - Country:US
Practice Address - Phone:516-546-8000
Practice Address - Fax:516-546-0499
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY315815164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse