1356355275 NPI number — DR. MARIAH MAGARGEE PIERETTI M.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356355275 NPI number — DR. MARIAH MAGARGEE PIERETTI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIERETTI
Provider First Name:
MARIAH
Provider Middle Name:
MAGARGEE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MAGARGEE
Provider Other First Name:
MARIAH
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356355275
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
840 HANSHAW RD
Provider Second Line Business Mailing Address:
ASTHMA AND ALLERGY ASSOCIATES, P.C.
Provider Business Mailing Address City Name:
ITHACA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14850-1589
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
607-257-6563
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
840 HANSHAW RD
Provider Second Line Business Practice Location Address:
ASTHMA AND ALLERGY ASSOCIATES, P.C.
Provider Business Practice Location Address City Name:
ITHACA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14850-1589
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-257-6563
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/28/2006

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: 2080P0204X , with the licence number:  233261 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207K00000X , with the licence number: 233261 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 02798121 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".