Provider Demographics
NPI:1558492322
Name:CYNTHIA V ALY- JEAN-PIERRE
Entity Type:Organization
Organization Name:CYNTHIA V ALY- JEAN-PIERRE
Other - Org Name:DR. CYNTHIA ALY-JEAN-PIERRE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:VALERIE
Authorized Official - Last Name:JEAN-PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-798-1512
Mailing Address - Street 1:517 FIFTH AVE
Mailing Address - Street 2:
Mailing Address - City:PICAYUNE
Mailing Address - State:MS
Mailing Address - Zip Code:39466-3203
Mailing Address - Country:US
Mailing Address - Phone:601-798-1512
Mailing Address - Fax:601-798-0448
Practice Address - Street 1:517 FIFTH AVE
Practice Address - Street 2:
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-3203
Practice Address - Country:US
Practice Address - Phone:601-798-1512
Practice Address - Fax:601-798-0448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS19428207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03428890Medicaid
MSP00634449OtherRAILROAD MEDICARE
MS160000715Medicare PIN
MSP00634449OtherRAILROAD MEDICARE