MEDICARE: MAURA E PEDROSO LLC

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	207R00000X	Internal Medicine Physician	25MA07746600	NJ
2	2084P0800X	Psychiatry Physician	25MA07746600	NJ

General Provider Information

NPI Number	:	1932404100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAURA E PEDROSO LLC

Provider Business Mailing Address
First Line	:	400 38TH ST STE 301
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-4848
Country	:	US
Telephone Number	:	201-884-1005
Fax Number	:	551-226-6488

Provider Business Practice Location Address
First Line	:	400 38TH ST STE 301
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-4848
Country	:	US
Telephone Number	:	201-884-1005
Fax Number	:	551-226-6488

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PEDROSO E MAURA
Credential	:	M.D
Telephone Number	:	917-407-7346

Provider Enumeration Date	:	01/20/2011
Last Update Date	:	04/12/2024

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Directions to “MAURA E PEDROSO LLC ” Practice Location

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