Provider Demographics
NPI:1588326524
Name:MYRIAM CORYE, LPN, P.C.
Entity type:Organization
Organization Name:MYRIAM CORYE, LPN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PRACTICAL NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:MYRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CORYE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:631-495-5165
Mailing Address - Street 1:23 ADAMS LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLE ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:11953-1802
Mailing Address - Country:US
Mailing Address - Phone:631-495-5165
Mailing Address - Fax:
Practice Address - Street 1:23 ADAMS LN
Practice Address - Street 2:
Practice Address - City:MIDDLE ISLAND
Practice Address - State:NY
Practice Address - Zip Code:11953-1802
Practice Address - Country:US
Practice Address - Phone:631-495-5165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty