MEDICARE: MRS. MYRIAM N PAREDES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	26NJ01092100	NJ

General Provider Information

NPI Number	:	1649863028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MYRIAM N PAREDES

Provider Business Mailing Address
First Line	:	14 EXETER ST
Second Line	:
City	:	OLD BRIDGE
State	:	NJ
Zip	:	08857-2202
Country	:	US
Telephone Number	:	732-688-8751
Fax Number	:

Provider Business Practice Location Address
First Line	:	408 NEW BRUNSWICK AVE
Second Line	:
City	:	FORDS
State	:	NJ
Zip	:	08863-2110
Country	:	US
Telephone Number	:	732-688-8751
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2021
Last Update Date	:	03/16/2025

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Directions to “ MRS. MYRIAM N PAREDES ” Practice Location

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