Provider Demographics
NPI:1366174468
Name:PIERRE LOUIS, JEAN MICHEL (MD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:MICHEL
Last Name:PIERRE LOUIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10 CHESTNUT ST APT A203
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5446
Mailing Address - Country:US
Mailing Address - Phone:184-559-8816
Mailing Address - Fax:
Practice Address - Street 1:10 CHESTNUT ST APT A203
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5446
Practice Address - Country:US
Practice Address - Phone:184-559-8819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHEL09241363AM0700X
INTS0001272.363AM0700X
PR001303-P.A.363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical