Provider Demographics
NPI:1598655995
Name:LOUISAIRE, AYESHA ETIENNA
Entity type:Individual
Prefix:MRS
First Name:AYESHA
Middle Name:ETIENNA
Last Name:LOUISAIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:AYESHA
Other - Middle Name:ETIENNA
Other - Last Name:DESIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:470 ROUTE 211 E STE 24
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2252
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:470 ROUTE 211 E
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2270
Practice Address - Country:US
Practice Address - Phone:845-524-1753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY353998363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily