Provider Demographics
NPI:1689817652
Name:PIERREPIERRE, DARLENE D (PA-C)
Entity type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:D
Last Name:PIERREPIERRE
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:DARLENE
Other - Middle Name:C
Other - Last Name:DAYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:379 CAMPUS DR FL 4
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1161
Mailing Address - Country:US
Mailing Address - Phone:732-937-8939
Mailing Address - Fax:732-418-8372
Practice Address - Street 1:110 REHILL AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2519
Practice Address - Country:US
Practice Address - Phone:908-685-2200
Practice Address - Fax:732-923-2272
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00198900363AS0400X, 363A00000X
PAMA053338363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ583000YP69OtherQSS PTAN
NJ583001ZJ5NOtherSSL PTAN
MP1900794OtherDEA REGISTRATION NUMBER