Healthcare Provider Details

I. General information

NPI: 1497307482
Provider Name (Legal Business Name): ALIX JEAN-PIERRE SR. LPN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 MERRICK RD
BALDWIN NY
11510-3334
US

IV. Provider business mailing address

927 MERRICK RD
BALDWIN NY
11510-3334
US

V. Phone/Fax

Practice location:
  • Phone: 347-401-0749
  • Fax:
Mailing address:
  • Phone: 347-401-0749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number271849
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: