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NPI Code Detail

MEDICARE: ANGELINA MARIE PICHARDO PA

MEDICARE: ANGELINA MARIE PICHARDO PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant25MP00606700NJ
2363AS0400XSurgical Physician AssistantNJ

General Provider Information

NPI Number : 1417526187
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELINA MARIE PICHARDO PA
Provider Business Mailing Address
First Line : 1 FEDERAL ST STE 200
Second Line :
City : CAMDEN
State : NJ
Zip : 08103-1088
Country : US
Telephone Number : 848-288-6935
Fax Number : 732-790-0107
Provider Business Practice Location Address
First Line : 215 N MAIN ST FL 2
Second Line :
City : CAPE MAY COURT HOUSE
State : NJ
Zip : 08210-2192
Country : US
Telephone Number : 609-778-1990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2021
Last Update Date : 03/17/2025

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Directions to “ ANGELINA MARIE PICHARDO PA” Practice Location

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