Provider Demographics
NPI:1669559951
Name:JORQUERA, PATRICIA (MD, FAAP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:JORQUERA
Suffix:
Gender:F
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MOTT AVE.
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850
Mailing Address - Country:US
Mailing Address - Phone:203-855-7551
Mailing Address - Fax:203-855-7624
Practice Address - Street 1:10 MOTT AVENUE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850
Practice Address - Country:US
Practice Address - Phone:203-855-7551
Practice Address - Fax:203-855-7624
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT037622208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics