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Individual

NELSON R PICHARDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
80 PASSAIC AVE, SUITE 1, PASSAIC, NJ 07055-4860
(973) 928-2167
(973) 928-2170
Mailing address
80 PASSAIC AVE, SUITE 1, PASSAIC, NJ 07055-4860
(973) 928-2167
(973) 928-2170

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2137731
NY
207R00000X
Internal Medicine Physician
Primary
25MA03887500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0066885
NJ
Enumeration date
03/09/2007
Last updated
02/22/2010
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