Provider Demographics
NPI:1760866453
Name:TAGNY, PIERRE BOSCO (STAFF NURSE)
Entity Type:Individual
Prefix:MR
First Name:PIERRE
Middle Name:BOSCO
Last Name:TAGNY
Suffix:
Gender:M
Credentials:STAFF NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 FREEPORT LOOP
Mailing Address - Street 2:APT# 6A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11239-2315
Mailing Address - Country:US
Mailing Address - Phone:347-605-3932
Mailing Address - Fax:
Practice Address - Street 1:1440 FREEPORT LOOP
Practice Address - Street 2:APT# 6A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11239-2315
Practice Address - Country:US
Practice Address - Phone:347-605-3932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY612407-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool