Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 1370991 | NY |
Y | 208000000X | Pediatrician | 1370991 | NY |
N | 2080P0201X | Pediatric Allergist | 137099 | NY |
NPI | 1245337047 |
---|---|
Provider Name | Michael E Pichichero |
First Address | Rochester, NY 14618 |
Second Address | Rochester, NY 14618 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 30/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000926103001 | HEALTH NOW (01) | |
00458833 | (05) | NY |
06901 | BLUE CROSS/BLUE SHIELD (01) | |
102310DL | PREFERRED CARE (01) | |
5866108 | AETNA (01) | |
F58617 | (02) | NY |
P010137099 | EXCELLUS (01) |