Provider Demographics
NPI:1831695279
Name:JANSSEN, PIERCE (MD)
Entity type:Individual
Prefix:
First Name:PIERCE
Middle Name:
Last Name:JANSSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 W 25TH ST APT 712
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-4152
Mailing Address - Country:US
Mailing Address - Phone:516-458-2618
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-6501
Practice Address - Country:US
Practice Address - Phone:216-444-6900
Practice Address - Fax:216-444-9419
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
OH35.150669208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program