1548439276 NPI number — MARYS CENTER FOR MATERNAL AND CHILD CARE

Table of content: DR. OCTAVIO ENRIQUE PAJARO M.D. (NPI 1629065677)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548439276 NPI number — MARYS CENTER FOR MATERNAL AND CHILD CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARYS CENTER FOR MATERNAL AND CHILD CARE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548439276
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2333 ONTARIO RD NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20009-2627
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-420-7031
Provider Business Mailing Address Fax Number:
202-332-0541

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
508 KENNEDY ST NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20011-3010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-545-2068
Provider Business Practice Location Address Fax Number:
202-545-6610
Provider Enumeration Date:
02/27/2008

Additional Information

Authorized Official

Authorized Official Last Name:
GAVIRIA
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
ANDRES
Authorized Official Title or Position:
RESEARCH ASSISTANT/ MENTAL HEALTH
Authorized Official Telephone Number:
202-545-2068

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  PRC13970 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com