1982315800 NPI number — JOLIE PIEDS PLLC

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 1982315800 NPI number — JOLIE PIEDS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOLIE PIEDS PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1982315800
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
380 LAFAYETTE RD UNIT 11
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEABROOK
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03874-4559
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7 PLEASANT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERRIMAC
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01860
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-233-1455
Provider Business Practice Location Address Fax Number:
978-288-0173
Provider Enumeration Date:
12/12/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ANDERSON
Authorized Official First Name:
MARIE
Authorized Official Middle Name:
PIERRE
Authorized Official Title or Position:
MANAGING MEMBER
Authorized Official Telephone Number:
978-228-0165

Provider Taxonomy Codes

  • Taxonomy code: 261QP1100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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