MEDICARE: DR. ELSIE JEAN-PIERRE LCSW, PH.D

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	103TC0700X	Clinical Psychologist	018319-1	NY

General Provider Information

NPI Number	:	1982760468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELSIE JEAN-PIERRE LCSW, PH.D

Provider Business Mailing Address
First Line	:	26 COURT ST
Second Line	:	SUITE 2111
City	:	BROOKLYN
State	:	NY
Zip	:	11242-0103
Country	:	US
Telephone Number	:	718-522-1500
Fax Number	:	718-522-1535

Provider Business Practice Location Address
First Line	:	26 COURT STREET
Second Line	:	SUITE 2111
City	:	BROOKLYN
State	:	NY
Zip	:	11242
Country	:	US
Telephone Number	:	718-522-1500
Fax Number	:	718-522-1535

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

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	05/07/2010

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