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NPI Code Detail

MEDICARE: DR. MANUELA G PEDRA-NOBRE M.D.

MEDICARE: DR. MANUELA G PEDRA-NOBRE M.D.
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
1207RR0500XRheumatology Physician25MA05738900NJ
2207RR0500XRheumatology PhysicianMA57389NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MA57389OTHERNJLICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912939844
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MANUELA G PEDRA-NOBRE M.D.
Provider Business Mailing Address
First Line : PO BOX 4606
Second Line : NORTH JERSEY RHEUMATOLOGY CENTER PA
City : WARREN
State : NJ
Zip : 07059
Country : US
Telephone Number : 908-233-9111
Fax Number : 908-233-9920
Provider Business Practice Location Address
First Line : 577 WESTFIELD AVE
Second Line :
City : WESTFIELD
State : NJ
Zip : 07090-3373
Country : US
Telephone Number : 908-233-9111
Fax Number : 908-233-9920
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 05/11/2011

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