MEDICARE: SIMONE VALERIE PIERRE

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	164W00000X	Licensed Practical Nurse	296683	NY

General Provider Information

NPI Number	:	1528294527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMONE VALERIE PIERRE

Provider Business Mailing Address
First Line	:	3614 AVE K
Second Line	:	APT C9
City	:	BROOKLYN
State	:	NY
Zip	:	11210
Country	:	US
Telephone Number	:	718-951-0343
Fax Number	:

Provider Business Practice Location Address
First Line	:	3614 AVE K
Second Line	:	APT C9
City	:	BROOKLYN
State	:	NY
Zip	:	11210
Country	:	US
Telephone Number	:	718-951-0343
Fax Number	:

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

Provider Enumeration Date	:	06/04/2009
Last Update Date	:	06/04/2009

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