Provider Demographics
NPI:1063467405
Name:PECORARO, ANTHONY PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:PAUL
Last Name:PECORARO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5349 W 102ND ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66207-3174
Mailing Address - Country:US
Mailing Address - Phone:913-649-4876
Mailing Address - Fax:
Practice Address - Street 1:4400 BROADWAY ST
Practice Address - Street 2:#206
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3498
Practice Address - Country:US
Practice Address - Phone:816-561-8100
Practice Address - Fax:816-561-8154
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3703208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics