Provider Demographics
NPI:1902169360
Name:OVIEDO, ADRIAN A (MSED)
Entity Type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:A
Last Name:OVIEDO
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 DEWEY PL
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3414
Mailing Address - Country:US
Mailing Address - Phone:201-907-0165
Mailing Address - Fax:
Practice Address - Street 1:255 DEWEY PL
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3414
Practice Address - Country:US
Practice Address - Phone:201-907-0165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist