Organization
PICHARDO HEALTH GROUP P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NELSON R. PICHARDO M.D. (MEDICAL DIRECTOR)
(973) 928-2167
Entity
Organization
Contact information
Practice address
80 PASSAIC AVE, SUITE 1, PASSAIC, NJ 07055-4860
(973) 928-2167
(973) 928-2170
Mailing address
80 PASSAIC AVE, SUITE 1, PASSAIC, NJ 07055-4860
(973) 928-2167
(973) 928-2170
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA03887500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0066885
—
NJ
Enumeration date
01/04/2010
Last updated
02/25/2010
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