JESUS PICHARDO MD PC NPI 1295902468

NPI Information

NPI: 1295902468
Provider Name: JESUS PICHARDO MD PC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
1623 WEIRFIELD ST
RIDGEWOOD, NY
ZIP 11385
Phone: (718) 456-4600
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JESUS PICHARDO MD PC is a primary care clinic center in Ridgewood, NY. JESUS PICHARDO MD PC NPI is 1295902468. The provider is registered as an organization entity type.

The provider's business location address is:

1623 WEIRFIELD ST
RIDGEWOOD, NY
ZIP 11385-349
Phone: (718) 456-4600
Fax: (718) 418-3549

The provider's authorized official is Jesus Manuel Pichardo .
The authorized official title is Pediatric and has the following contact phone number (718) 456-4600.

The enumeration date for this NPI number is 5/15/2008 and was last updated on 4/16/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	188066	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01463212	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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