Provider Demographics
NPI:1922479146
Name:PICHARDO, NORMA (APN)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:PICHARDO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 HARRISTOWN RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-3329
Mailing Address - Country:US
Mailing Address - Phone:201-855-8301
Mailing Address - Fax:
Practice Address - Street 1:625 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1977
Practice Address - Country:US
Practice Address - Phone:973-742-2228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00594500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily