Provider Demographics
NPI:1992944318
Name:MILIEN, MARIE CARMEL
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:CARMEL
Last Name:MILIEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:CARMEL
Other - Last Name:JEAN LOUIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22604 141ST AVE
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2707
Mailing Address - Country:US
Mailing Address - Phone:718-723-1684
Mailing Address - Fax:
Practice Address - Street 1:22604 141ST AVE
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-2707
Practice Address - Country:US
Practice Address - Phone:718-723-1684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY295734164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse