Provider Demographics
NPI:1154160117
Name:TELEMAQUE, LAURETTE MICHARTINE (APN)
Entity type:Individual
Prefix:MISS
First Name:LAURETTE
Middle Name:MICHARTINE
Last Name:TELEMAQUE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MRS
Other - First Name:LAURETTE
Other - Middle Name:MICHARTINE
Other - Last Name:CHARLES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APN
Mailing Address - Street 1:1 STYSLY LN
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-2510
Mailing Address - Country:US
Mailing Address - Phone:845-642-2913
Mailing Address - Fax:
Practice Address - Street 1:1 STYSLY LN
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-2510
Practice Address - Country:US
Practice Address - Phone:845-642-2913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR19513500163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice