Provider Demographics
NPI:1932111754
Name:PIERRE, NEDJIE MARIE (DPM)
Entity Type:Individual
Prefix:DR
First Name:NEDJIE
Middle Name:MARIE
Last Name:PIERRE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 LINDEN BLVD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203
Mailing Address - Country:US
Mailing Address - Phone:347-533-4577
Mailing Address - Fax:347-533-4581
Practice Address - Street 1:432 LINDEN BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:347-533-4577
Practice Address - Fax:347-533-4581
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005538213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU75282Medicare UPIN
A300001678Medicare PIN