Provider Demographics
NPI:1912417247
Name:JEAN-BAPTISTE, MARIE CLAUDE (INTERN)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:CLAUDE
Last Name:JEAN-BAPTISTE
Suffix:
Gender:F
Credentials:INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13711 243RD ST
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-1823
Mailing Address - Country:US
Mailing Address - Phone:347-221-6785
Mailing Address - Fax:
Practice Address - Street 1:40 ELMONT RD
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-1603
Practice Address - Country:US
Practice Address - Phone:917-907-1136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-29
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program