Provider Demographics
NPI:1386671287
Name:PINEDA, VERNE M (MD)
Entity Type:Individual
Prefix:
First Name:VERNE
Middle Name:M
Last Name:PINEDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 EVESHAM RD
Mailing Address - Street 2:SUITE 605
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4507
Mailing Address - Country:US
Mailing Address - Phone:856-772-0111
Mailing Address - Fax:856-772-2838
Practice Address - Street 1:2301 EVESHAM RD
Practice Address - Street 2:SUITE 605
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4507
Practice Address - Country:US
Practice Address - Phone:856-772-0111
Practice Address - Fax:856-772-2838
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA027519207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ285401Medicaid
NJ054580Medicare ID - Type Unspecified
C52817Medicare UPIN