=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891821609
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ORIN HUGH PEARCE M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2007
-----------------------------------------------------
Last Update Date | 11/27/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21626 JAMAICA AVE
-----------------------------------------------------
City | QUEENS VILLAGE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11428-2121
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-217-1602
-----------------------------------------------------
Fax | 718-217-1790
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21626 JAMAICA AVE
-----------------------------------------------------
City | QUEENS VILLAGE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11428-2121
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-217-1602
-----------------------------------------------------
Fax | 718-217-1790
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 180484
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 180484
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------