Provider Demographics
NPI:1053133181
Name:PACHECO, ASHLEY (APN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:PACHECO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:HOPELAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-1526
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:122 HOWARD ST
Practice Address - Street 2:
Practice Address - City:HOPELAWN
Practice Address - State:NJ
Practice Address - Zip Code:08861-1526
Practice Address - Country:US
Practice Address - Phone:732-770-2585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2022044204363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology