Provider Demographics
NPI:1598747198
Name:PADIN, FREDERICO ALFAFARA (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICO
Middle Name:ALFAFARA
Last Name:PADIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:150 PROSPECT AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323-2542
Mailing Address - Country:US
Mailing Address - Phone:814-437-6212
Mailing Address - Fax:814-432-7604
Practice Address - Street 1:150 PROSPECT AVE STE 201
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-2555
Practice Address - Country:US
Practice Address - Phone:814-437-6212
Practice Address - Fax:814-432-7604
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030554L208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006680000001Medicaid
205281OtherUPMC HEALTH INS
PA1962719153OtherGROUP NPI
205281OtherUPMC HEALTH INS