Agency Information

PET ASSURE CORP

Address:

211 BOULEVARD OF AMERICAS STE 403

LAKEWOOD, NJ 8701-4778

Phone

732-987-3781

URL:

Email:

rachelo@petbenefits.com

National Producer Number:

18875614

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Independent Adjuster	4009527	05/17/2024	Active	05/17/2024	05/31/2027
Non-Res. Producer Firm	3364575	08/17/2018	Active	08/17/2018	08/31/2027

Qualification Type	Original Issue Date	Status	Effective Date
Adj - Property and Casualty	05/17/2024	Active	05/17/2024
Casualty	08/17/2018	Active	08/17/2018
Property	08/17/2018	Active	08/17/2018

Company Name	Appointment Type	Status	Active Date
597
EVERSPAN INSURANCE COMPANY	Casualty	Active	09/17/2024
	Property	Active	09/17/2024
11242
Company Name	Appointment Type	Status	Active Date
INDEPENDENCE AMERICAN INSURANCE COMPANY	Casualty	Active	06/28/2023
	Property	Active	06/28/2023
551
Company Name	Appointment Type	Status	Active Date
PROVIDENCE WASHINGTON INSURANCE COMPANY	Casualty	Active	03/26/2025
	Property	Active	03/26/2025

row(s) 1 - 6 of 6

Name	Association Type	Agent	Begin Date	End Date
ALLISON V BARBATO	Designated Resp Lic Adjuster	No	05/17/2024	-
CHAYA MIRIAM NOCHOMOVITZ	Designated Resp Lic Prdcr	Yes	10/01/2020	-

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