Provider Demographics
NPI:1760804686
Name:PIERRECIUS, REGINA (NP)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:PIERRECIUS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 E 37TH ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3239
Mailing Address - Country:US
Mailing Address - Phone:347-501-1666
Mailing Address - Fax:
Practice Address - Street 1:177 E 87TH ST STE 502
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-2226
Practice Address - Country:US
Practice Address - Phone:212-744-2345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-11
Last Update Date:2014-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF306714-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health