Individual provider Active NPI

Marie Darbouze

  • Licensed Practical Nurse
  • Staten Island, NY
National Provider Identifier
1073988234
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
324314-1 Issued in NY
Practice address
411 Wilcox St
Staten Island, NY 10303-2153
Phone
(718) 730-3883
NPI assigned
Dec 14, 2015
Last updated
Dec 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 324314-1 NY Primary

Addresses

Primary practice location

411 Wilcox St
Staten Island, NY 10303-2153

Mailing address

411 Wilcox St
Staten Island, NY 10303-2153
Phone (718) 730-3883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
324314-1NYMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1073988234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 WILCOX ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032153",
            "telephone_number": "718-730-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WILCOX ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032153",
            "telephone_number": "718-730-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARBOUZE",
        "first_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-14",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "324314-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.