Provider Demographics
NPI:1699212878
Name:PECORELLA, JANET LOUISE
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LOUISE
Last Name:PECORELLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 PORLAND AVE.
Mailing Address - Street 2:SUITE #1
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-2731
Mailing Address - Country:US
Mailing Address - Phone:585-544-3430
Mailing Address - Fax:585-544-3473
Practice Address - Street 1:1295 PORLAND AVE.
Practice Address - Street 2:SUITE #1
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-2731
Practice Address - Country:US
Practice Address - Phone:585-544-3430
Practice Address - Fax:585-544-3473
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
006782-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician