Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 27OA00678100 | NJ |
N | 152W00000X | Optometrist | 632 | PR |
NPI | 1003956699 |
---|---|
Provider Name | Dr. Monique Marie Pacheco |
First Address | Hackettstown, NJ 07840-2715 |
Second Address | East Hanover, NJ 07936-3564 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 12/03/2021 |