Provider Demographics
NPI:1336935469
Name:REMY-JOCELYN, MYLDRAIDE (BSN)
Entity type:Individual
Prefix:
First Name:MYLDRAIDE
Middle Name:
Last Name:REMY-JOCELYN
Suffix:
Gender:
Credentials:BSN
Other - Prefix:MS
Other - First Name:MYLDRAIDE
Other - Middle Name:
Other - Last Name:REMY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN-BSN
Mailing Address - Street 1:97 CARLETON AVE APT A
Mailing Address - Street 2:
Mailing Address - City:ISLIP TERRACE
Mailing Address - State:NY
Mailing Address - Zip Code:11752-2238
Mailing Address - Country:US
Mailing Address - Phone:631-720-8275
Mailing Address - Fax:631-720-8275
Practice Address - Street 1:998 CROOKED HILL ROAD
Practice Address - Street 2:BUILDING # 1
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717
Practice Address - Country:US
Practice Address - Phone:631-434-7247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY542643-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse