Individual ProviderMarie LissadeRegistered NurseNursing Service ProvidersPractice Address6 Murin St, Spring Valley, NY 10977-4841(845) 290-5187PECOS EnrollmentBased on the most recent information from CMS, provider Marie Lissade 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 11:54 AM.Profile DetailsProvider ID1982950317Provider TypeIndividualFull NameLissade, MarieGenderFemaleSole ProprietorYesEnumeration Date8/3/2012Last Updated8/3/2012Contact InformationPractice LocationPractice Address6 Murin St, Spring Valley, NY 10977-4841Phone(845) 290-5187FaxUnlisted FaxMailing LocationMailing Address6 Murin St., Spring Valley, NY 10977Phone(845) 290-5187FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense650783New York