Provider Demographics
NPI:1033154141
Name:PEDROSO, MAURA E (MD)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:E
Last Name:PEDROSO
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 1:506 3RD ST.
Mailing Address - Street 2:HUMC CMHC
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030
Mailing Address - Country:US
Mailing Address - Phone:646-789-2122
Mailing Address - Fax:
Practice Address - Street 1:19 W 34TH ST # W
Practice Address - Street 2:PENTHOUSE FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3006
Practice Address - Country:US
Practice Address - Phone:646-789-2122
Practice Address - Fax:188-887-6409
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212036207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine