Fajardo, Mildred Therese

Fajardo, Mildred Therese is an individual health care provider with primary practice located at 620 Howard Ave , Altoona PA 16601-4804. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Psychosomatic Medicine. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Fajardo, Mildred Therese can be contacted via phone (814) 942-5000.

Contact Information

Primary practice address
620 Howard Ave Altoona PA 16601-4804
Phone: (814) 942-5000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD436495 Pennsylvania
Allopathic & Osteopathic Physicians / Psychosomatic Medicine 2084P0015X MD436495 Pennsylvania

Profile Details

NPI number 1023223351
LBN Legal business name Fajardo, Mildred Therese
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2007
Last updated Jul 11th, 2011 - 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 1023223351 NPPES
Pennsylvania MEDICAID 1024996330001

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