Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 001840 | NY |
NPI | 1124532205 |
---|---|
Provider Name | Mervnide Pierre |
First Address | New York, NY 10032-3917 |
Second Address | New York, NY 10032-3917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2017 |
Last Update Date | 22/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001840 | NYS OFFICE OF THE PROFESSIONS (01) | NY |