Provider Demographics
NPI:1144210659
Name:PION, IRA A (MD)
Entity Type:Individual
Prefix:
First Name:IRA
Middle Name:A
Last Name:PION
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:949 CENTRAL AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1204
Mailing Address - Country:US
Mailing Address - Phone:516-295-1921
Mailing Address - Fax:516-295-9304
Practice Address - Street 1:949 CENTRAL AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1204
Practice Address - Country:US
Practice Address - Phone:516-295-1921
Practice Address - Fax:516-295-9304
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY195835207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01553671Medicaid
NYIP055J3210OtherBLUE CROSS
NY01553671Medicaid
55J3219181Medicare PIN