1588296974 NPI number — MRS. EILEEN A PIERRO EDM, RDN, LD

Table of content: MRS. EILEEN A PIERRO EDM, RDN, LD (NPI 1588296974)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588296974 NPI number — MRS. EILEEN A PIERRO EDM, RDN, LD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIERRO
Provider First Name:
EILEEN
Provider Middle Name:
A
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
EDM, RDN, LD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FIGUEROA PIERRO
Provider Other First Name:
EILEEN
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
EDM, RDN, LD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1588296974
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
34 HAVERHILL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01841-2884
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-686-0090
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
109 DRINKWATER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMPTON FALLS
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03844
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-247-2998
Provider Business Practice Location Address Fax Number:
603-775-0020
Provider Enumeration Date:
02/04/2020

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: 133V00000X , with the licence number:  1057 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 133V00000X , with the licence number: 1921 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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