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General NPI Number Information
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NPI Number | 1336124841
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Entity Type | Individual
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Provider Name | WILFRED FAISCA M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/08/2005
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Last Update Date | 05/03/2012
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Provider Practice Location Address
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Address Line | CARRETERA 845 KM. 3.2 D-32 FAIR VIEW
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City | RIO PIEDRAS
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-755-6354
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Fax | 787-755-3285
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Provider Business Mailing Address
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Address Line | PO BOX 1799
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City | TRUJILLO ALTO
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State | PR
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Zip | 00977-1799
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Country | US
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Telephone | 787-755-6354
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Fax | 787-755-3285
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 5131
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License Number State | PR
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