Ileana Fajardo D.P.T.

NPI 1194004275 - Specialist - 174400000X

NPI Details
NPI 1194004275
Gender Female
Enumeration Date 08/08/2011
Last Updated 08/08/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
415 AVENEL ST
AVENEL NJ, 07001-1147, US
Phone (732) 693-6788
Fax (732) 636-7887
Business Location
415 AVENEL ST
AVENEL NJ, 07001-1147, US
Phone (732) 693-6788
Fax (732) 636-7887
Toxanomy
Taxonomy Code 174400000X
License State New Jersey
License Number 40QA01384600
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According to our database, Dr. Ileana Fajardo D.P.T. NPI is 1194004275, taxonomy code is 174400000X and license number is 40QA01384600, license state is located at New Jersey. Ileana Fajardo D.P.T. physically located at 415 Avenel St, Avenel NJ, 07001-1147. NPI Number Ileana Fajardo D.P.T. has the Individual type.

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1194004275 NPI number is provided on an as is basis without warranty of any kind. 1194004275 is maintained by the National Plan & Provider Enumeration System. The contents of Ileana Fajardo D.P.T. are for informational purposes only.