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Individual

ROBERT JAMES PICKERAL JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
53-59 PUBLIC SQ STE 301, WATERTOWN, NY 13601-2674
(315) 782-2141
(315) 782-5123
Mailing address
53-59 PUBLIC SQ STE 301, WATERTOWN, NY 13601-2674
(315) 786-8700
(315) 782-5123

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
024741
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
024741
NEW YORK STATE
NY
Enumeration date
02/19/2020
Last updated
03/03/2020
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