Provider Demographics
NPI:1689817652
Name:PIERREPIERRE, DARLENE D (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:D
Last Name:PIERREPIERRE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DARLENE
Other - Middle Name:C
Other - Last Name:DAYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:695 US HIGHWAY 46
Mailing Address - Street 2:STE 400A
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-1568
Mailing Address - Country:US
Mailing Address - Phone:973-894-1265
Mailing Address - Fax:973-894-6480
Practice Address - Street 1:695 US HIGHWAY 46 STE 400A
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-1568
Practice Address - Country:US
Practice Address - Phone:973-826-8080
Practice Address - Fax:888-309-3354
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053338363A00000X
NJ25MP00198900363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ583000YP69OtherQSS PTAN
NJ583001ZJ5NOtherSSL PTAN
MP1900794OtherDEA REGISTRATION NUMBER