Individual
GIL V FAJARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
333 60TH ST, WEST NEW YORK, NJ 07093
(201) 453-8777
(201) 453-8804
Mailing address
47 RAMBLING DRIVE, SCOTCH PLAINS, NJ 07076
(201) 453-8777
(201) 453-8804
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MA62055
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7003803
—
NJ
Enumeration date
11/01/2006
Last updated
07/08/2007
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