Provider Demographics
NPI:1508017070
Name:DALLEMAND, PIERRE URBAIN
Entity Type:Individual
Prefix:MR
First Name:PIERRE
Middle Name:URBAIN
Last Name:DALLEMAND
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 1:20954 110TH AVE
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429-1825
Mailing Address - Country:US
Mailing Address - Phone:718-775-1870
Mailing Address - Fax:
Practice Address - Street 1:20954 110TH AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11429-1825
Practice Address - Country:US
Practice Address - Phone:718-775-1870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287647-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse