Individual
NIDIA PICHARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
B65 CALLE BATAVIA, BAYAMON, PR 00956-2807
(956) 877-1128
Mailing address
B65 CALLE BATAVIA, URB. FOREST VIEW, BAYAMON, PR 00956-2807
(956) 877-1128
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2048
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2048
PHYSICIAN ASSISTANT LICENSE
PR
Enumeration date
01/26/2024
Last updated
01/28/2024
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