Provider Demographics
NPI:1417058520
Name:COMSTI DEPERIO PINEDA AND ASSOCIATES LLC
Entity Type:Organization
Organization Name:COMSTI DEPERIO PINEDA AND ASSOCIATES LLC
Other - Org Name:PHYSICIANS FOR ADULTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NONATO
Authorized Official - Middle Name:ESPIRITU
Authorized Official - Last Name:PINEDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-657-8111
Mailing Address - Street 1:681 ROUTE 70
Mailing Address - Street 2:
Mailing Address - City:LAKEHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:08733-2853
Mailing Address - Country:US
Mailing Address - Phone:732-657-8111
Mailing Address - Fax:732-657-7828
Practice Address - Street 1:681 ROUTE 70
Practice Address - Street 2:
Practice Address - City:LAKEHURST
Practice Address - State:NJ
Practice Address - Zip Code:08733-2853
Practice Address - Country:US
Practice Address - Phone:732-657-8111
Practice Address - Fax:732-657-7828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ056531Medicare ID - Type UnspecifiedGROUP PROVIDER IDENT NUMB