Provider Demographics
NPI:1457667958
Name:PIERROT, MARIE Y (PA)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:Y
Last Name:PIERROT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 E 17TH ST
Mailing Address - Street 2:2ND FLOOR FIERMAN HALL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3804
Mailing Address - Country:US
Mailing Address - Phone:212-420-2885
Mailing Address - Fax:212-844-1762
Practice Address - Street 1:317 E 17TH ST
Practice Address - Street 2:2ND FLOOR FIERMAN HALL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3804
Practice Address - Country:US
Practice Address - Phone:212-420-2885
Practice Address - Fax:212-844-1762
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005109363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant