Provider Demographics
NPI:1871556456
Name:PIERRE, MARCIEN (OD)
Entity type:Individual
Prefix:DR
First Name:MARCIEN
Middle Name:
Last Name:PIERRE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-1014
Mailing Address - Country:US
Mailing Address - Phone:516-841-7238
Mailing Address - Fax:718-554-1553
Practice Address - Street 1:1619 PITKIN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-5045
Practice Address - Country:US
Practice Address - Phone:718-342-4300
Practice Address - Fax:347-350-6601
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004928152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY001092213Medicaid
NY001092213Medicaid
T49089Medicare UPIN