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NPI Code Detail

MEDICARE: JANICE CAMILLE FAJARDO SUMAGUE P.T.

MEDICARE: JANICE CAMILLE FAJARDO SUMAGUE P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT017763PA

General Provider Information

NPI Number : 1043339781
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANICE CAMILLE FAJARDO SUMAGUE P.T.
Provider Business Mailing Address
First Line : 224 BARNHILL RD
Second Line :
City : PERKASIE
State : PA
Zip : 18944-4415
Country : US
Telephone Number : 215-534-7879
Fax Number :
Provider Business Practice Location Address
First Line : 777 FERRY RD
Second Line :
City : DOYLESTOWN
State : PA
Zip : 18901-2102
Country : US
Telephone Number : 215-340-5195
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 04/10/2012

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