Provider Demographics
NPI:1578776969
Name:PAJELA, PEDRO RAMOS (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:RAMOS
Last Name:PAJELA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 PRISCILLA LN
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2313
Mailing Address - Country:US
Mailing Address - Phone:201-568-0690
Mailing Address - Fax:
Practice Address - Street 1:321 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-5304
Practice Address - Country:US
Practice Address - Phone:718-518-3789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115309207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00212331Medicaid
NYPP0584662Medicare ID - Type Unspecified
NY00212331Medicaid