Provider Demographics
NPI:1093177974
Name:PIERRE PAUL, MARIE
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:PIERRE PAUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 SUSSEX RD
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-1422
Mailing Address - Country:US
Mailing Address - Phone:151-649-1052
Mailing Address - Fax:
Practice Address - Street 1:39 SUSSEX RD
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-1422
Practice Address - Country:US
Practice Address - Phone:151-649-1052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299846-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse