Dr Carmine Pecoraro Psy D & Associates P a

Primary specialty

CounselorTaxonomy code 101Y00000X

License

PY7477 Issued in FL

Legal business name

DR CARMINE PECORARO PSY D & ASSOCIATES P A

Practice address

915 Middle River Dr
317
Ft Lauderdale, FL 33304-3544

Phone

(954) 463-2723

Fax

(954) 463-1687

NPI assigned

Apr 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Judith Ann Pecoraro, BS, CBHT

Title

Vice President

Phone

(954) 829-4644

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1093933590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 MIDDLE RIVER DR",
            "address_2": "317",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043544",
            "telephone_number": "954-463-2723",
            "fax_number": "954-463-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 MIDDLE RIVER DR",
            "address_2": "317",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043544",
            "telephone_number": "954-463-2723",
            "fax_number": "954-463-1687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR CARMINE PECORARO PSY D & ASSOCIATES P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "PECORARO",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "954-829-4644",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BS, CBHT"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "FL",
            "license": "PY7477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AF405",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.