Provider Demographics
NPI:1154708006
Name:JEAN BAPTISTE, MARIE AIMEE (PA)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:AIMEE
Last Name:JEAN BAPTISTE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14843 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-3330
Mailing Address - Country:US
Mailing Address - Phone:347-561-9581
Mailing Address - Fax:347-561-6955
Practice Address - Street 1:14843 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-3330
Practice Address - Country:US
Practice Address - Phone:347-561-9581
Practice Address - Fax:347-561-6955
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006089363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical