Provider Demographics
NPI:1346400488
Name:PEIRCE, CLAIR (LPN)
Entity Type:Individual
Prefix:MR
First Name:CLAIR
Middle Name:
Last Name:PEIRCE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:CLARA
Other - Middle Name:PARVALHO
Other - Last Name:PEIRCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:271 11TH SQUARE SW
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32962
Mailing Address - Country:US
Mailing Address - Phone:914-262-6936
Mailing Address - Fax:
Practice Address - Street 1:2 MADISON AVENUE
Practice Address - Street 2:SUITE - #103
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538
Practice Address - Country:US
Practice Address - Phone:914-262-6936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2190331164W00000X
FLPN5157512164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02630968Medicaid