Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MA069676 | NJ |
N | 111NI0900X | Internist | MA069676 | NJ |
N | 207SG0201X | Clinical Genetics (M.D.) | MA069676 | NJ |
N | 208000000X | Pediatrician | MA069676 | NJ |
NPI | 1215983382 |
---|---|
Provider Name | Dr. Helio F Pedro |
First Address | Newark, NJ 07103-2757 |
Second Address | Newark, NJ 07103-2757 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H11346 | (02) |