Provider Demographics
NPI:1093830127
Name:PECORA, JOLANTA ALICIA (MACCCA)
Entity Type:Individual
Prefix:MRS
First Name:JOLANTA
Middle Name:ALICIA
Last Name:PECORA
Suffix:
Gender:F
Credentials:MACCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 MAIN ST
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-4204
Mailing Address - Country:US
Mailing Address - Phone:860-225-7761
Mailing Address - Fax:860-225-6657
Practice Address - Street 1:233 MAIN ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-4204
Practice Address - Country:US
Practice Address - Phone:860-225-7761
Practice Address - Fax:860-225-6657
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist