Provider Demographics
NPI:1134961444
Name:PINEDA LAGOS, FARAH CAROLINA (MD)
Entity type:Individual
Prefix:
First Name:FARAH
Middle Name:CAROLINA
Last Name:PINEDA LAGOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FARAH
Other - Middle Name:CAROLINA
Other - Last Name:PINEDA LAGOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:117 N 15TH ST APT 1806
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1520
Mailing Address - Country:US
Mailing Address - Phone:475-323-0492
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-757-7904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program