Healthcare Provider Details

I. General information

NPI: 1811764889
Provider Name (Legal Business Name): LOURDES MALDONADO-VIERA MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2023
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WESCOTT DR
FLEMINGTON NJ
08822-4603
US

IV. Provider business mailing address

PO BOX 622
FRANKLIN LAKES NJ
07417-0622
US

V. Phone/Fax

Practice location:
  • Phone: 908-300-3700
  • Fax: 201-847-0059
Mailing address:
  • Phone: 908-300-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: LOURDES MALDONADO-VIERA
Title or Position: PRESIDENT
Credential: MD
Phone: 908-300-3700