Provider Demographics
NPI:1467147272
Name:MUSAFIRI, PIERRE
Entity Type:Individual
Prefix:
First Name:PIERRE
Middle Name:
Last Name:MUSAFIRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HIGH STREET
Mailing Address - Street 2:APT#1
Mailing Address - City:LISBON
Mailing Address - State:ME
Mailing Address - Zip Code:04250
Mailing Address - Country:US
Mailing Address - Phone:207-240-7179
Mailing Address - Fax:
Practice Address - Street 1:182 EAST AVE APT 1
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5512
Practice Address - Country:US
Practice Address - Phone:207-240-7179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-07
Last Update Date:2023-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME253Z00000X, 3104A0625X, 372500000X, 251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty