Provider Demographics
NPI:1811235955
Name:PHAREL, PIERRE E (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PIERRE
Middle Name:E
Last Name:PHAREL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CALLE TULANE
Mailing Address - Street 2:APT 31 COND UNIVERSITY PLAZA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-4922
Mailing Address - Country:US
Mailing Address - Phone:787-565-1411
Mailing Address - Fax:
Practice Address - Street 1:29 CALLE WASHINGTON
Practice Address - Street 2:SUITE 107, ASHFORD MEDICAL PLAZA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:787-722-0412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4312103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR004312OtherLICENSE