Provider Demographics
NPI:1316269772
Name:JOLIMERE, ELMIRE AZIANE
Entity type:Individual
Prefix:
First Name:ELMIRE
Middle Name:AZIANE
Last Name:JOLIMERE
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 1:27 PORTER RD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3328
Mailing Address - Country:US
Mailing Address - Phone:862-520-9472
Mailing Address - Fax:
Practice Address - Street 1:27 PORTER RD
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3328
Practice Address - Country:US
Practice Address - Phone:862-520-9472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268420164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse