Provider Demographics
NPI:1548601594
Name:PASTRANO LLUBERES, MAGNA JOSEFINA (MD)
Entity Type:Individual
Prefix:
First Name:MAGNA
Middle Name:JOSEFINA
Last Name:PASTRANO LLUBERES
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 1:53 PATRICK AVE
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1462
Mailing Address - Country:US
Mailing Address - Phone:973-906-3779
Mailing Address - Fax:
Practice Address - Street 1:186 ROCHELLE AVE
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-4122
Practice Address - Country:US
Practice Address - Phone:551-996-9230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-07
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT54721207R00000X
NJ25MA10571100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine