Provider Demographics
NPI:1003956699
Name:PACHECO, MONIQUE MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:MARIE
Last Name:PACHECO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 OSPREY
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2715
Mailing Address - Country:US
Mailing Address - Phone:908-850-5043
Mailing Address - Fax:908-850-5043
Practice Address - Street 1:389 ROUTE 10
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-3564
Practice Address - Country:US
Practice Address - Phone:973-781-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR632152W00000X
NJ27OA00678100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist