Provider Demographics
NPI:1699074674
Name:PIERRO, FABYAN
Entity type:Individual
Prefix:MRS
First Name:FABYAN
Middle Name:
Last Name:PIERRO
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 1:280 BELLMORE ROAD
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3538
Mailing Address - Country:US
Mailing Address - Phone:516-353-3017
Mailing Address - Fax:516-735-7421
Practice Address - Street 1:280 BELLMORE ROAD
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-3538
Practice Address - Country:US
Practice Address - Phone:516-353-3017
Practice Address - Fax:516-735-7421
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY098585164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse