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General NPI Number Information
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NPI Number | 1922078997
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Entity Type | Individual
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Provider Name | JACQUES PICHE M.D., F.R.S.C. (C)
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Gender | Male
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 06/28/2012
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Provider Practice Location Address
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Address Line | 10 HEALEY AVE
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City | PLATTSBURGH
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State | NY
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Zip | 12901-2413
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Country | US
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Telephone | 518-566-7930
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Fax | 518-566-7932
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Provider Business Mailing Address
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Address Line | 10 HEALEY AVE
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City | PLATTSBURGH
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State | NY
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Zip | 12901-2413
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Country | US
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Telephone | 518-566-7930
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Fax | 518-566-7932
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 219568-1
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License Number State | NY
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