Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 233726 | NY |
NPI | 1023083391 |
---|---|
Provider Name | Dr. Jacqueline Melissa Marecheau |
First Address | Brooklyn, NY 11215-4802 |
Second Address | Brooklyn, NY 11215-4802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 11/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01430280 | (05) | NY |
752E71 | (02) | NY |