Provider Demographics
NPI:1033718085
Name:PALLIATIVE CARE CONSULTING SERVICES LLC
Entity Type:Organization
Organization Name:PALLIATIVE CARE CONSULTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:DR
Authorized Official - First Name:GANNEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN-PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:203-219-7896
Mailing Address - Street 1:382 HIGH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-3019
Mailing Address - Country:US
Mailing Address - Phone:203-219-7896
Mailing Address - Fax:
Practice Address - Street 1:1188 FOX ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-1810
Practice Address - Country:US
Practice Address - Phone:203-219-7896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care