Leide Etienne, is a
Licensed Practical Nurse based in Glen Ridge, New Jersey. Leide Etienne is licensed to practice in New York (license number 269725) and her current practice location is
174 Bay Ave, Glen Ridge, New Jersey. She can be reached at her office (for appointments etc.) via phone at
(862) 218-8625.
NPI number for Leide Etienne is 1659736106 and her current mailing address is 174 Bay Ave, Glen Ridge, New Jersey. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1659736106.
Provider's Profile
| Full Name | Leide Etienne |
|---|
| Gender | Female |
|---|
| Speciality | Licensed Practical Nurse |
|---|
| Location | 174 Bay Ave, Glen Ridge, New Jersey |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1659736106
- Provider Enumeration Date: 12/29/2015
- Last Update Date: 12/29/2015
Medical Identifiers
Medical identifiers for Leide Etienne such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659736106 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | 269725 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Leide Etienne is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Leide Etienne,
174 Bay Ave,
Glen Ridge, NJ 07028-2404
Ph: () - | Leide Etienne,
174 Bay Ave,
Glen Ridge, NJ 07028-2404
Ph: (862) 218-8625 |
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