Healthcare Provider Details

I. General information

NPI: 1437819604
Provider Name (Legal Business Name): ANDREA MICHELE BIERRIA M.S. SPED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2021
Last Update Date: 12/29/2021
Certification Date: 12/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 SPRING ST
MONTICELLO NY
12701-2201
US

IV. Provider business mailing address

12 POND HILL LN
WALDEN NY
12586-2264
US

V. Phone/Fax

Practice location:
  • Phone: 845-717-1841
  • Fax:
Mailing address:
  • Phone: 917-565-2258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: