1588074835 NPI number — MS. RUTH EVELYN PIERCE II MSW/CASAC

Table of content: MS. RUTH EVELYN PIERCE II MSW/CASAC (NPI 1588074835)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588074835 NPI number — MS. RUTH EVELYN PIERCE II MSW/CASAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIERCE
Provider First Name:
RUTH
Provider Middle Name:
EVELYN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
II
Provider Credential Text:
MSW/CASAC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588074835
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
201 WEST 147TH STREET
Provider Second Line Business Mailing Address:
APT. 4B
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
347-510-3422
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 W 147TH ST
Provider Second Line Business Practice Location Address:
APT. 4B
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10039-3445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-694-4026
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/07/2014

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: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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