Healthcare Provider Details

I. General information

NPI: 1396701900
Provider Name (Legal Business Name): CHRISTOPHER G PIERSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2006
Last Update Date: 11/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 MONMOUTH RD STE 202
W LONG BRANCH NJ
07764
US

IV. Provider business mailing address

241 MONMOUTH RD STE 202
W LONG BRANCH NJ
07764
US

V. Phone/Fax

Practice location:
  • Phone: 732-923-9603
  • Fax: 732-923-9096
Mailing address:
  • Phone: 732-923-9603
  • Fax: 732-923-9096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMA65534
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: