Provider Demographics
NPI:1932404100
Name:MAURA E PEDROSO LLC
Entity Type:Organization
Organization Name:MAURA E PEDROSO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDROSO
Authorized Official - Middle Name:E
Authorized Official - Last Name:MAURA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-407-7346
Mailing Address - Street 1:400 38TH ST STE 301
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-4848
Mailing Address - Country:US
Mailing Address - Phone:201-884-1005
Mailing Address - Fax:551-226-6488
Practice Address - Street 1:400 38TH ST STE 301
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-4848
Practice Address - Country:US
Practice Address - Phone:201-884-1005
Practice Address - Fax:551-226-6488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07746600207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty