MEDICARE: CARMEN JEAN PIERRE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	148465-1	NY

General Provider Information

NPI Number	:	1043448137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN JEAN PIERRE

Provider Business Mailing Address
First Line	:	548 E 40TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-5618
Country	:	US
Telephone Number	:	718-826-1331
Fax Number	:

Provider Business Practice Location Address
First Line	:	548 E 40TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-5618
Country	:	US
Telephone Number	:	718-826-1331
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2009
Last Update Date	:	06/26/2009

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Directions to “ CARMEN JEAN PIERRE ” Practice Location

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