Provider Demographics
NPI:1629531165
Name:PECORARO, VALENTINA SUZANNA (MD)
Entity Type:Individual
Prefix:DR
First Name:VALENTINA
Middle Name:SUZANNA
Last Name:PECORARO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 JACK MARTIN BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-7778
Mailing Address - Country:US
Mailing Address - Phone:732-458-8000
Mailing Address - Fax:732-458-8020
Practice Address - Street 1:495 JACK MARTIN BLVD STE 5
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7778
Practice Address - Country:US
Practice Address - Phone:732-458-8000
Practice Address - Fax:732-458-8020
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA11647800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program