Individual
BRENDA FAJARDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
701 ROUTE 211 E, MIDDLETOWN, NY 10941-1413
(845) 692-2422
Mailing address
701 ROUTE 211 E, MIDDLETOWN, NY 10941-1413
(845) 692-2422
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
053360
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01465989
—
NY
Enumeration date
10/05/2009
Last updated
10/05/2009
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