| Jesus Pichardo Md Pc | |
|
1623 Weirfield St Ridgewood NY 11385-5349 | |
| (718) 456-4600 | |
| (718) 418-3549 |
| Full Name | Jesus Pichardo Md Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1623 Weirfield St, Ridgewood, New York |
| Authorized Official Name and Position | Jesus Manuel Pichardo (PEDIATRIC) |
| Authorized Official Contact | 7184564600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jesus Pichardo Md Pc 1623 Weirfield Street Ridgewood NY 11385 Ph: (718) 456-4600 | Jesus Pichardo Md Pc 1623 Weirfield St Ridgewood NY 11385-5349 Ph: (718) 456-4600 |
| NPI Number | 1295902468 |
|---|---|
| Provider Enumeration Date | 05/15/2008 |
| Last Update Date | 04/16/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295902468 | NPI | - | NPPES |
| 01463212 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 188066 (New York) | Primary |
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