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Individual

DR. JESUS MANUEL PICHARDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1623 WEIRFIELD ST, RIDGEWOOD, NY 11385-5349
(718) 456-4600
(718) 418-3549
Mailing address
1623 WEIRFIELD ST, RIDGEWOOD, NY 11385-5349
(718) 456-4600
(718) 418-3549

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
188066
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01463212
NY
Enumeration date
11/29/2006
Last updated
10/28/2025
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