MEDICARE: PEDRO G ROBLEJO MD

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	208800000X	Urology Physician	25MA02346000	NJ

General Provider Information

NPI Number	:	1639360282
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDRO G ROBLEJO MD

Provider Business Mailing Address
First Line	:	5910 PALISADE AVE
Second Line	:
City	:	WEST NEW YORK
State	:	NJ
Zip	:	09093-2112
Country	:	US
Telephone Number	:	201-868-0821
Fax Number	:	201-868-0160

Provider Business Practice Location Address
First Line	:	5910 PALISADE AVE
Second Line	:
City	:	WEST NEW YORK
State	:	NJ
Zip	:	09093-2112
Country	:	US
Telephone Number	:	201-868-0821
Fax Number	:	201-868-0160

Authorized Official
Title or Position	:	MD UROLOGIST
Name	:	PEDRO GONZALO ROBLEJO
Credential	:	MEDICAL DOCTOR
Telephone Number	:	201-868-0821

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	08/08/2007

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