Provider Demographics
NPI:1023326527
Name:FILS-AIME, MARIE SONIE (NP)
Entity type:Individual
Prefix:MISS
First Name:MARIE
Middle Name:SONIE
Last Name:FILS-AIME
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400-H HORSEBLOCK ROAD
Mailing Address - Street 2:SUITE H
Mailing Address - City:FARMINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11788
Mailing Address - Country:US
Mailing Address - Phone:631-451-2211
Mailing Address - Fax:
Practice Address - Street 1:400-H HORSEBLOCK ROAD
Practice Address - Street 2:SUITE H
Practice Address - City:FARMINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:11788
Practice Address - Country:US
Practice Address - Phone:631-451-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF304223-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health