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General NPI Number Information
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NPI Number | 1275224537
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Entity Type | Individual
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Provider Name | STEPHANIE MARIE PICHARDO CPNP-PC
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Gender | Female
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Dates
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Enumeration Date | 05/17/2023
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 1411 MYRTLE AVE
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City | BROOKLYN
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State | NY
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Zip | 11237-4512
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Country | US
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Telephone | 718-907-4301
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Fax |
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Provider Business Mailing Address
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Address Line | 10415 35TH AVE APT 3F
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City | CORONA
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State | NY
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Zip | 11368-1972
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Country | US
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Telephone | 347-701-0359
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 383508
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License Number State | NY
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