Provider Demographics
NPI:1023108248
Name:LESPINASSE, PIERRE FREDERIC (MD)
Entity type:Individual
Prefix:DR
First Name:PIERRE
Middle Name:FREDERIC
Last Name:LESPINASSE
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 1:828 BLOOMFIELD AVE
Mailing Address - Street 2:APT 7C
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-1870
Mailing Address - Country:US
Mailing Address - Phone:973-746-0250
Mailing Address - Fax:
Practice Address - Street 1:444 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-2213
Practice Address - Country:US
Practice Address - Phone:973-675-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07359200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0033871Medicaid
NJ084833Medicare ID - Type Unspecified
NJ0033871Medicaid