NPI 1457615460 · live from the CMS NPI Registry
Emelynn Joanne Fajardo, D.O.
Pediatrics, Sports Medicine in Wilmington, DE. National Provider Identifier 1457615460, active.
NPI record
| NPI | 1457615460 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Pediatrics, Sports Medicine 2080S0010X |
| Practice location | 1600 Rockland Rd, Wilmington, DE 19803 |
| Practice phone | 302-651-4200 |
| Mailing address | Po Box 191, Rockland, DE 19732 |
| Enumerated | June 25, 2012 |
| Last updated | April 29, 2019 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatrics, Sports Medicine primary | 2080S0010X | C2-0013079 (DE) |
| Pediatrics, Sports Medicine | 2080S0010X | 25mb09117500 (NJ) |
| Pediatrics, Sports Medicine | 2080S0010X | OS019939 (PA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.