Provider Demographics
NPI:1518393594
Name:PECORI, AIMEE K (OD)
Entity type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:K
Last Name:PECORI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 E MAIN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:GOUVERNEUR
Mailing Address - State:NY
Mailing Address - Zip Code:13642-1510
Mailing Address - Country:US
Mailing Address - Phone:315-535-1700
Mailing Address - Fax:
Practice Address - Street 1:173 E MAIN ST APT 1
Practice Address - Street 2:
Practice Address - City:GOUVERNEUR
Practice Address - State:NY
Practice Address - Zip Code:13642-1510
Practice Address - Country:US
Practice Address - Phone:315-535-1700
Practice Address - Fax:315-535-1700
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV008077152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist