Organization
JESUS PICHARDO MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESUS MANUEL PICHARDO M.D. (PEDIATRIC)
(718) 456-4600
Entity
Organization
Contact information
Practice address
1623 WEIRFIELD ST, RIDGEWOOD, NY 11385-5349
(718) 456-4600
(718) 418-3549
Mailing address
1623 WEIRFIELD STREET, RIDGEWOOD, NY 11385
(718) 456-4600
(718) 418-3549
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
188066
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01463212
—
NY
Enumeration date
05/15/2008
Last updated
04/16/2013
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