Provider Demographics
NPI:1003178369
Name:PACHECO, JULIO CESAR JR (MA, BEA)
Entity Type:Individual
Prefix:MR
First Name:JULIO
Middle Name:CESAR
Last Name:PACHECO
Suffix:JR
Gender:M
Credentials:MA, BEA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1 SAMANTHA WAY
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-2951
Mailing Address - Country:US
Mailing Address - Phone:551-265-7316
Mailing Address - Fax:
Practice Address - Street 1:2510 WESTCHESTER AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3512
Practice Address - Country:US
Practice Address - Phone:718-597-5558
Practice Address - Fax:718-823-5494
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1186207174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist