Provider Demographics
NPI:1164438271
Name:PECORA, JANINE M (PA)
Entity Type:Individual
Prefix:MRS
First Name:JANINE
Middle Name:M
Last Name:PECORA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 FRIES MILL RD
Mailing Address - Street 2:N-3
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-8319
Mailing Address - Country:US
Mailing Address - Phone:856-875-8000
Mailing Address - Fax:856-875-8494
Practice Address - Street 1:188 FRIES MILL RD
Practice Address - Street 2:SUITE N3
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2015
Practice Address - Country:US
Practice Address - Phone:856-875-8000
Practice Address - Fax:856-875-8494
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMP00287363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPE004589Medicare ID - Type Unspecified
S48996Medicare UPIN