Individual provider Active NPI

Marie Michelle Faustin, REGISTERED NURSE

  • Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1225396567
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
454897 Issued in NY
Practice address
655 Parkside Ave
Private Address
Brooklyn, NY 11226-1505
Phone
(718) 941-0320
Fax
(718) 941-3152
NPI assigned
Apr 24, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 454897 NY Primary

Addresses

Primary practice location

655 Parkside Ave
Private Address
Brooklyn, NY 11226-1505

Mailing address

3212 Mott Ave
Private House
Far Rockaway, NY 11691-1621
Phone (347) 246-7883

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
454897NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1225396567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 MOTT AVE",
            "address_2": "PRIVATE HOUSE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911621",
            "telephone_number": "347-246-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 PARKSIDE AVE",
            "address_2": "PRIVATE ADDRESS",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112261505",
            "telephone_number": "718-941-0320",
            "fax_number": "718-941-3152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUSTIN",
        "first_name": "MARIE",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-24",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "454897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; 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.