| Doctor Name: | MR. DOUGLAS ALLEN PEARCE |
| NPI Number: | 1144623778 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP |
| License Number: | 339168 |
| Business Practice Address: | 860 Main Rd Corfu, NY - 140369753 |
| Business Phone Number: | 5855996446 |
| Business Fax Number: | 5855993166 |
| Mailing Address: | 13 Ryan St, LANCASTER |
| State: | NY |
| Postal Code: | 140869445 |
| Phone Number: | 7162086988 |
| Fax Number: | |
| NPI Enumeration Date: | 09/26/2014 |
| NPI Last Update Date: | 09/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 339168 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |