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Elaine C. Fajardo

Internal Medicine

Allopathic & Osteopathic Physicians

20 York Street, Cb-2041, New Haven, CT 06510

PECOS Enrollment

This provider is enrolled in PECOS as ELAINE FAJARDO.

Based on the most recent information from CMS, provider Elaine C. Fajardo is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:14 PM.

Profile Details

Provider ID
1316163124
Provider Type
Individual
Full Name
Fajardo, Elaine C.
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
4/18/2007
Last Updated
6/14/2011

Contact Information

Practice Location

20 York Street, Cb-2041, New Haven, CT 06510

(203) 688-4748

(203) 688-4740

Mailing Location

20 York Street Cb-2041, New Haven, CT 06510

(203) 688-4748

(203) 688-4740

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 049771 Connecticut
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License A93850 California
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License 250219 New York
Code 207RC0200X	Description Internal Medicine Allopathic & Osteopathic Physicians	License 250219 New York
Code 207RP1001X	Description Internal Medicine Allopathic & Osteopathic Physicians	License 250219 New York
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License 049771 Connecticut

Elaine C. Fajardo

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

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License

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