Provider Demographics
NPI:1376350686
Name:MAILO, JANETTE (MD)
Entity type:Individual
Prefix:DR
First Name:JANETTE
Middle Name:
Last Name:MAILO
Suffix:
Gender:F
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:DIVISION OF PEDIATRIC NEUROLOGY
Mailing Address - Street 2:1919 E THOMAS ROAD
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016
Mailing Address - Country:US
Mailing Address - Phone:602-933-4688
Mailing Address - Fax:
Practice Address - Street 1:DIVISION OF PEDIATRIC NEUROLOGY
Practice Address - Street 2:1919 E THOMAS ROAD
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016
Practice Address - Country:US
Practice Address - Phone:602-933-4688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ733402084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Multi-Specialty