Provider Demographics
NPI:1235323460
Name:ROBERT PICCIANO, M.D. & MARIA VIEIRA PICCIANO, M.D., P.C.
Entity Type:Organization
Organization Name:ROBERT PICCIANO, M.D. & MARIA VIEIRA PICCIANO, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FATIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SENDAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-578-4808
Mailing Address - Street 1:36 PACIFIC STREET
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105
Mailing Address - Country:US
Mailing Address - Phone:973-578-4808
Mailing Address - Fax:973-578-2939
Practice Address - Street 1:36 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-1665
Practice Address - Country:US
Practice Address - Phone:973-578-4808
Practice Address - Fax:973-578-2939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05550400207R00000X
NJ25MA05674900207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF48621Medicare UPIN
NJE77285Medicare UPIN