Healthcare Provider Details

I. General information

NPI: 1760804686
Provider Name (Legal Business Name): REGINA PIERRECIUS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2014
Last Update Date: 01/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 E 87TH ST STE 502
NEW YORK NY
10128-2226
US

IV. Provider business mailing address

309 E 37TH ST APT 4A
NEW YORK NY
10016-3239
US

V. Phone/Fax

Practice location:
  • Phone: 212-744-2345
  • Fax:
Mailing address:
  • Phone: 347-501-1666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF306714-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: