MEDICARE: PIERRE JONAS JOACHIM NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11028308	FL

General Provider Information

NPI Number	:	1013798776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PIERRE JONAS JOACHIM NP

Provider Business Mailing Address
First Line	:	725 FOUNTAIN AVE APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-5403
Country	:	US
Telephone Number	:	646-363-5045
Fax Number	:

Provider Business Practice Location Address
First Line	:	725 FOUNTAIN AVE APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-5403
Country	:	US
Telephone Number	:	646-363-5045
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	10/09/2023

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