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General NPI Number Information
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NPI Number | 1194673640
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Entity Type | Individual
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Provider Name | ANDREA LAVON MARIE PINCHOM FNP
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Gender | Female
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Dates
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Enumeration Date | 03/19/2026
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Last Update Date | 03/19/2026
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Provider Practice Location Address
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Address Line | 126 PREAKNESS AVE
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City | PATERSON
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State | NJ
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Zip | 07522-1436
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Country | US
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Telephone | 201-598-9727
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Fax |
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Provider Business Mailing Address
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Address Line | 126 PREAKNESS AVE FL 2
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City | PATERSON
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State | NJ
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Zip | 07522-1436
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Country | US
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Telephone | 201-598-9727
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NR24453200
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License Number State | NJ
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