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Individual

NICHOLAS T PECORELLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
245 VALLEY BLVD, WOOD-RIDGE, NJ 07075-1236
(201) 438-5500
(201) 438-3363
Mailing address
245 VALLEY BLVD, WOOD-RIDGE, NJ 07075-1236
(201) 438-5500
(201) 438-3363

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA06462500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110207170
RR MEDICARE
NJ
01
1K5877
HEALTHNET
NJ
01
5151665
AETNA PPO
NJ
05
7088407
NJ
01
8097769
CIGNA HMO
NJ
01
P867458
OXFORD
NJ
Enumeration date
03/14/2006
Last updated
12/04/2012
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