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1790007516
DORMELISE DERISME
QUEENS VILLAGE, NY
NPI
1790007516
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 294962)
Enumeration Date
2010-02-21
Last Update Date
2010-02-21
Business Address
-- DORMELISE DERISME
22121 JAMAICA AVE
QUEENS VILLAGE, NY 11428-2015
Phone number: 718-468-6923
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Mailing Address
-- DORMELISE DERISME
22121 JAMAICA AVE
QUEENS VILLAGE, NY 11428-2015
Phone number:
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