Provider Demographics
NPI:1952880312
Name:POIRIER, ANDRE S (RN)
Entity Type:Individual
Prefix:
First Name:ANDRE
Middle Name:S
Last Name:POIRIER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8545 PERSIAN TER
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:NY
Mailing Address - Zip Code:13039-8855
Mailing Address - Country:US
Mailing Address - Phone:315-558-9213
Mailing Address - Fax:
Practice Address - Street 1:8545 PERSIAN TER
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:NY
Practice Address - Zip Code:13039-8855
Practice Address - Country:US
Practice Address - Phone:315-558-9213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY476061163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics