Individual
NICOLE JARDIN PECQUEX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11 NEVINS ST, SUITE 201, BRIGHTON, MA 02135-3514
(617) 789-2442
(617) 202-4349
Mailing address
960 MASSACHUSETTS AVE, FL 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
219025
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110035692A
—
MA
05
—
2031370
—
MA
05
—
3079850
—
NH
Enumeration date
09/16/2005
Last updated
06/12/2026
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