Provider Demographics
NPI:1043714256
Name:CAMACHO-PICHARDO, DADJERE
Entity Type:Individual
Prefix:MRS
First Name:DADJERE
Middle Name:
Last Name:CAMACHO-PICHARDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 S 5TH ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-6465
Mailing Address - Country:US
Mailing Address - Phone:917-498-0007
Mailing Address - Fax:
Practice Address - Street 1:367 S 5TH ST APT 4A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-6465
Practice Address - Country:US
Practice Address - Phone:917-498-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist