Provider Demographics
NPI:1174764526
Name:PIERCE-OKE, TINA
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:PIERCE-OKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 ROCHAMBEAU AVE
Mailing Address - Street 2:APT 3-B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-3724
Mailing Address - Country:US
Mailing Address - Phone:718-885-7199
Mailing Address - Fax:
Practice Address - Street 1:3204 ROCHAMBEAU AVE
Practice Address - Street 2:APT 3-B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-3724
Practice Address - Country:US
Practice Address - Phone:718-885-7199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296322164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse