Individual ProviderMarie LouiseLicensed Practical NurseNursing Service ProvidersPractice Address365 Broadway Ste 4a, Amityville, NY 11701-271616360885231631681771PECOS EnrollmentBased on the most recent information from CMS, provider Marie Louise does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1720692601Provider TypeIndividualFull NameLouise, MarieTitleMs.GenderFemaleSole ProprietorYesEnumeration Date9/8/2020Last Updated9/9/2020Contact InformationPractice LocationPractice Address365 Broadway Ste 4a, Amityville, NY 11701-2716Phone1636088523FaxUnlisted FaxMailing LocationMailing Address29 Woodlawn Ave, Selden, NY 11784-3256Phone1631681771FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense334710New York