Individual
MR. JAMES R. PICKARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1075 WHITING RD, JORDAN, NY 13080-9749
(315) 689-3896
(315) 689-7280
Mailing address
1075 WHITING RD, JORDAN, NY 13080-9749
(315) 689-3896
(315) 689-7280
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
161165267
NY
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01639303
—
NY
01
—
02082626
HCBS TBI MEDICAID WAIVER
NY
01
—
161165267
BC/BS
NY
Enumeration date
02/13/2007
Last updated
09/30/2009
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