Provider Demographics
NPI:1669461224
Name:PECORA, ALFRED A (DC)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:A
Last Name:PECORA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8836 BAY 16TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5902
Mailing Address - Country:US
Mailing Address - Phone:718-236-7950
Mailing Address - Fax:718-228-2479
Practice Address - Street 1:8836 BAY 16TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5902
Practice Address - Country:US
Practice Address - Phone:718-236-7950
Practice Address - Fax:718-228-2479
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000944-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX06691Medicare ID - Type UnspecifiedPROVIDER #
NYT51795Medicare UPIN