Provider Demographics
NPI:1093987471
Name:PARDO, JANINE RACHEL (MD)
Entity type:Individual
Prefix:DR
First Name:JANINE
Middle Name:RACHEL
Last Name:PARDO
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 1:134 SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-1923
Mailing Address - Country:US
Mailing Address - Phone:781-472-2222
Mailing Address - Fax:
Practice Address - Street 1:134 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-1923
Practice Address - Country:US
Practice Address - Phone:781-472-2222
Practice Address - Fax:781-907-7112
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY384967207R00000X
MA257107207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine