1801140256 NPI number — DR. SHERYL LORI PIERRE PHD

Table of content: DR. SHERYL LORI PIERRE PHD (NPI 1801140256)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801140256 NPI number — DR. SHERYL LORI PIERRE PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIERRE
Provider First Name:
SHERYL
Provider Middle Name:
LORI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PIERRE
Provider Other First Name:
SHERYL
Provider Other Middle Name:
LORI
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1801140256
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
128 BORTONS LANDING ROAD
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
MOORESTOWN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-780-6293
Provider Business Mailing Address Fax Number:
856-780-6294

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
128 BORTONS LANDING ROAD
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
MOORESTOWN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-780-6293
Provider Business Practice Location Address Fax Number:
856-780-6294
Provider Enumeration Date:
11/07/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC2200X , with the licence number:  35SI00537600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)