Provider Demographics
NPI:1508380718
Name:PIESIK, MARTHA IRENE
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:IRENE
Last Name:PIESIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 RED SPRING RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3437
Mailing Address - Country:US
Mailing Address - Phone:978-601-0698
Mailing Address - Fax:
Practice Address - Street 1:48 RED SPRING RD
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3437
Practice Address - Country:US
Practice Address - Phone:978-601-0698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator