MEDICARE: DR. JOELLE PIERRE MD

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	2086S0120X	Pediatric Surgery Physician	25MA08979700	NJ

General Provider Information

NPI Number	:	1528265279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOELLE PIERRE MD

Provider Business Mailing Address
First Line	:	PO BOX 19 ONE ROBERT WOOD JOHNSON PLACE
Second Line	:	DEPARTMENT OF PEDIATRIC SURGERY
City	:	NEW BRUNSWICK
State	:	NJ
Zip	:	08903-0019
Country	:	US
Telephone Number	:	732-235-7821
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 MINEOLA BLVD STE 210
Second Line	:
City	:	MINEOLA
State	:	NY
Zip	:	11501-4077
Country	:	US
Telephone Number	:	516-663-4600
Fax Number	:

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

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	10/24/2022

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