Provider Demographics
NPI:1134937220
Name:EIGHTY 8TH NP IN ADULT HEALTH P.C
Entity type:Organization
Organization Name:EIGHTY 8TH NP IN ADULT HEALTH P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:GUERLINE
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:347-636-4005
Mailing Address - Street 1:1214 E 88TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4916
Mailing Address - Country:US
Mailing Address - Phone:347-636-4005
Mailing Address - Fax:
Practice Address - Street 1:1817 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4854
Practice Address - Country:US
Practice Address - Phone:347-636-4005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-21
Last Update Date:2024-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care