Individual ProviderHenry EtienneRegistered NurseNursing Service ProvidersPractice Address13 Truman Ct, Middletown, NY 10940-4512(732) 829-4303PECOS EnrollmentBased on the most recent information from CMS, provider Henry Etienne 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 2 days ago.Profile DetailsProvider ID1972926897Provider TypeIndividualFull NameEtienne, HenryGenderMaleSole ProprietorYesEnumeration Date1/28/2014Last Updated1/28/2014Contact InformationPractice LocationPractice Address13 Truman Ct, Middletown, NY 10940-4512Phone(732) 829-4303FaxUnlisted FaxMailing LocationMailing Address13 Truman Ct, Middletown, NY 10940-4512Phone(732) 829-4303FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense573870-1New York