Pellicoro, Jill A

Pellicoro, Jill A is an individual health care provider with primary practice located at 9692 Pennsylvania Ave , Upper Marlboro MD 20772-3670. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Pellicoro, Jill A can be contacted via phone (301) 599-7300.

Contact Information

Primary practice address
9692 Pennsylvania Ave Upper Marlboro MD 20772-3670
Phone: (301) 599-7300
Fax: (301) 599-0476
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X D0055269 Maryland
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X D0055269 Maryland

Profile Details

NPI number 1285770214
LBN Legal business name Pellicoro, Jill A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 29th, 2007
Last updated Feb 7th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285770214 NPPES
Maryland MEDICAID 407983300

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