Provider Demographics
NPI:1851841431
Name:PIERRILUS, NEOMIE (RN)
Entity Type:Individual
Prefix:
First Name:NEOMIE
Middle Name:
Last Name:PIERRILUS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 RENSSELAER DR
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1828
Mailing Address - Country:US
Mailing Address - Phone:845-461-1664
Mailing Address - Fax:
Practice Address - Street 1:11 RENSSELAER DR
Practice Address - Street 2:A
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1828
Practice Address - Country:US
Practice Address - Phone:845-461-1664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7099271163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice