Provider Demographics
NPI:1962042580
Name:FAJUROKI, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:FAJUROKI
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 1:11550 CROSSROADS CIR UNIT 451
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2978
Mailing Address - Country:US
Mailing Address - Phone:832-475-4243
Mailing Address - Fax:
Practice Address - Street 1:3005 EMMORTON RD
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-2023
Practice Address - Country:US
Practice Address - Phone:410-569-1870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-11
Last Update Date:2020-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27070183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist