Provider Demographics
NPI:1578875431
Name:MAIDANA MORENO, MARIA BEATRIZ (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:BEATRIZ
Last Name:MAIDANA MORENO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:316 COPPOLA DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-2359
Mailing Address - Country:US
Mailing Address - Phone:732-865-4401
Mailing Address - Fax:
Practice Address - Street 1:145 HENRY ST APT 1G
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-2554
Practice Address - Country:US
Practice Address - Phone:718-858-4924
Practice Address - Fax:718-522-4954
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY283912208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics