Provider Demographics
NPI:1598786337
Name:PESCI RODRIGUEZ, PAULA MARIE
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:MARIE
Last Name:PESCI RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:MARIE
Other - Last Name:PESCI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1 GLIMPSEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-3767
Mailing Address - Country:US
Mailing Address - Phone:973-539-0885
Mailing Address - Fax:973-292-3293
Practice Address - Street 1:139 SOUTH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974-1999
Practice Address - Country:US
Practice Address - Phone:973-615-9217
Practice Address - Fax:973-292-3293
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA047652002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry