Provider Demographics
NPI:1255840054
Name:PECORARO, STEPHEN (HAD)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:PECORARO
Suffix:
Gender:M
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 2ND AVE FL 9
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5645
Mailing Address - Country:US
Mailing Address - Phone:212-979-4621
Mailing Address - Fax:212-353-5731
Practice Address - Street 1:380 2ND AVE FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5645
Practice Address - Country:US
Practice Address - Phone:212-979-4621
Practice Address - Fax:212-353-5731
Is Sole Proprietor?:No
Enumeration Date:2017-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000051201237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist