Provider Demographics
NPI:1497307482
Name:JEAN-PIERRE, ALIX (LPN)
Entity Type:Individual
Prefix:
First Name:ALIX
Middle Name:
Last Name:JEAN-PIERRE
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 WINTHROP DR
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-3025
Mailing Address - Country:US
Mailing Address - Phone:347-401-0749
Mailing Address - Fax:
Practice Address - Street 1:680 WINTHROP DR
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-3025
Practice Address - Country:US
Practice Address - Phone:347-401-0749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271849164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse