Healthcare Provider Details

I. General information

NPI: 1548928609
Provider Name (Legal Business Name): PIERCE NOLAN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2021
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 WHITE PLAINS RD STE 510
TARRYTOWN NY
10591-5152
US

IV. Provider business mailing address

580 WHITE PLAINS RD
TARRYTOWN NY
10591-5198
US

V. Phone/Fax

Practice location:
  • Phone: 914-345-5900
  • Fax:
Mailing address:
  • Phone: 914-345-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number408028
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number713037
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: