Provider Demographics
NPI:1376580415
Name:ROBERTI, MARIA ISABEL (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ISABEL
Last Name:ROBERTI
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 1:70 TULIP ST
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-2458
Mailing Address - Country:US
Mailing Address - Phone:908-273-3573
Mailing Address - Fax:
Practice Address - Street 1:94 OLD SHORT HILLS RD
Practice Address - Street 2:SUITE 304 EAST WING
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-5264
Practice Address - Fax:973-322-2315
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06363700208000000X
NJ636372080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6841503Medicaid
NJG03156Medicare UPIN
NJ6841503Medicaid