Basic Information
Provider Information
NPI: 1245584028
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAINT-HILAIRE
FirstName: MICHELINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 484 COOLIDGE AVE
Address2:  
City: ROCKVILLE CENTRE
State: NY
PostalCode: 115703306
CountryCode: US
TelephoneNumber: 7184686923
FaxNumber:  
Practice Location
Address1: 484 COOLIDGE AVE
Address2:  
City: ROCKVILLE CENTRE
State: NY
PostalCode: 115703306
CountryCode: US
TelephoneNumber: 7184686923
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/01/2012
LastUpdateDate: 11/01/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000X310741NYY Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


Home