Provider Demographics
NPI:1801102611
Name:JANVIER-DUMORNAY, MARIE MAGALIE
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:MAGALIE
Last Name:JANVIER-DUMORNAY
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 1:1791 BARD LN
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1503
Mailing Address - Country:US
Mailing Address - Phone:516-413-4623
Mailing Address - Fax:
Practice Address - Street 1:1791 BARD LN
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1503
Practice Address - Country:US
Practice Address - Phone:516-413-4623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY840923163W00000X
NY301806164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No163W00000XNursing Service ProvidersRegistered Nurse