Provider Demographics
NPI:1437819604
Name:BIERRIA, ANDREA MICHELE (MS SPED)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MICHELE
Last Name:BIERRIA
Suffix:
Gender:F
Credentials:MS SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 POND HILL LN
Mailing Address - Street 2:
Mailing Address - City:WALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:12586-2264
Mailing Address - Country:US
Mailing Address - Phone:917-565-2258
Mailing Address - Fax:
Practice Address - Street 1:13 SPRING ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-2201
Practice Address - Country:US
Practice Address - Phone:845-717-1841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care