MEDICARE: MERRY COMMUNITY EDUCATION FOUNDATION MRS. MERYTONY PIERRE JEAN 0DM/COUNSELOR

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	374U00000X	Home Health Aide
2	101YP1600X	Pastoral Counselor

General Provider Information

NPI Number	:	1891253472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERRY COMMUNITY EDUCATION FOUNDATION MRS. MERYTONY PIERRE JEAN 0DM/COUNSELOR

Provider Business Mailing Address
First Line	:	2841 KNORR ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-2518
Country	:	US
Telephone Number	:	267-608-0073
Fax Number	:

Provider Business Practice Location Address
First Line	:	2841 KNORR ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-2518
Country	:	US
Telephone Number	:	267-608-0073
Fax Number	:

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

Provider Enumeration Date	:	03/03/2019
Last Update Date	:	05/19/2022

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