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General NPI Number Information
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NPI Number | 1336148873
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Entity Type | Individual
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Provider Name | JEFFREY PINCO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 08/26/2019
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Provider Practice Location Address
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Address Line | 5755 CEDAR LN DEPT OF
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City | COLUMBIA
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State | MD
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Zip | 21044
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Country | US
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Telephone | 410-740-7861
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Fax |
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Provider Business Mailing Address
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Address Line | 3911 WHITE ROSE WAY
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-5801
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Country | US
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Telephone | 443-741-0798
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | D78866
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | MD047570
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License Number State | DC
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