Provider Demographics
NPI:1104500024
Name:PIERRE, DJENANE MADMIRKA (PA)
Entity type:Individual
Prefix:
First Name:DJENANE
Middle Name:MADMIRKA
Last Name:PIERRE
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:603-319-8308
Practice Address - Street 1:471 CENTER ST
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:MA
Practice Address - Zip Code:01056-2733
Practice Address - Country:US
Practice Address - Phone:413-625-3500
Practice Address - Fax:413-625-3655
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program