Provider Demographics
NPI:1154857878
Name:PIERRE, SUSANNE C (RN)
Entity Type:Individual
Prefix:
First Name:SUSANNE
Middle Name:C
Last Name:PIERRE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10820 AVENUE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4616
Mailing Address - Country:US
Mailing Address - Phone:718-578-0765
Mailing Address - Fax:
Practice Address - Street 1:13750 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-3610
Practice Address - Country:US
Practice Address - Phone:718-298-5100
Practice Address - Fax:718-298-5130
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY435918163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health