Provider Demographics
NPI:1952464554
Name:PIERRE-LOUIS, MAGALIE (MD)
Entity Type:Individual
Prefix:
First Name:MAGALIE
Middle Name:
Last Name:PIERRE-LOUIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 E 40TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4424
Mailing Address - Country:US
Mailing Address - Phone:917-392-0376
Mailing Address - Fax:
Practice Address - Street 1:3743 76TH ST
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6533
Practice Address - Country:US
Practice Address - Phone:917-392-0376
Practice Address - Fax:718-677-4043
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192096208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01842204Medicaid
NYI02561Medicare UPIN
NY6B1271Medicare ID - Type Unspecified