Provider Demographics
NPI:1942436316
Name:DAMIAN-COLEMAN, MARIA MYRANDELE (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:MYRANDELE
Last Name:DAMIAN-COLEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:MYRANDELE
Other - Last Name:DAMIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:2025 HAMBURG TPKE STE C
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-6250
Practice Address - Country:US
Practice Address - Phone:201-957-7220
Practice Address - Fax:201-977-6747
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08567900207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology