Provider Demographics
NPI:1487741104
Name:PIERRE, JOSE S (OD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:S
Last Name:PIERRE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7 BELL ST APT 210
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2234
Mailing Address - Country:US
Mailing Address - Phone:973-393-7155
Mailing Address - Fax:
Practice Address - Street 1:300 WOOTTON ST
Practice Address - Street 2:
Practice Address - City:BOONTON
Practice Address - State:NJ
Practice Address - Zip Code:07005-1925
Practice Address - Country:US
Practice Address - Phone:973-299-1730
Practice Address - Fax:973-299-1733
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00598400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist