Provider Demographics
NPI:1962861435
Name:JUSTE, MARIE S (LPN)
Entity Type:Individual
Prefix:MISS
First Name:MARIE
Middle Name:S
Last Name:JUSTE
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 1:511 PORTLAND AVE
Mailing Address - Street 2:PH
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-2547
Mailing Address - Country:US
Mailing Address - Phone:516-510-6829
Mailing Address - Fax:
Practice Address - Street 1:511 PORTLAND AVE
Practice Address - Street 2:PH
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-2547
Practice Address - Country:US
Practice Address - Phone:516-510-6829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292039-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse