Provider Demographics
NPI:1346886439
Name:PAREDES, MARIA-CECILIA GUADALUPE
Entity Type:Individual
Prefix:
First Name:MARIA-CECILIA
Middle Name:GUADALUPE
Last Name:PAREDES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 W 55TH ST
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-2226
Mailing Address - Country:US
Mailing Address - Phone:551-697-1631
Mailing Address - Fax:
Practice Address - Street 1:545 FIRST AVENUE
Practice Address - Street 2:GREENBERG HALL C-124
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:347-963-8257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-23
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY689011-1163W00000X
NYF309307-01363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse