Provider Demographics
NPI:1205859865
Name:BIER, JEREMY A (DPM)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:A
Last Name:BIER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5305
Mailing Address - Country:US
Mailing Address - Phone:203-975-9600
Mailing Address - Fax:203-323-8430
Practice Address - Street 1:1100 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5305
Practice Address - Country:US
Practice Address - Phone:203-975-9600
Practice Address - Fax:203-323-8430
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000693213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004196657Medicaid
CT004196657Medicaid
CT480000919Medicare PIN