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General NPI Number Information
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NPI Number | 1477792455
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Entity Type | Organization
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Legal Business Name | PAJARO MEDICAL
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Dates
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Enumeration Date | 02/13/2009
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Last Update Date | 02/13/2009
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Provider Practice Location Address
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Address Line | 32 GROVE ST
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City | CHESTER
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State | NJ
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Zip | 07930-3606
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Country | US
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Telephone | 908-879-2008
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Fax | 908-879-2006
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Provider Business Mailing Address
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Address Line | 32 GROVE ST
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City | CHESTER
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State | NJ
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Zip | 07930-3606
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAFAEL PAJARO
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Credential | M.D., M.S.
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Telephone | 908-879-2008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA05972900
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License Number State | NJ
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