Provider Demographics
NPI:1548229891
Name:PINEDA, NONATO ESPIRITU (MD)
Entity type:Individual
Prefix:DR
First Name:NONATO
Middle Name:ESPIRITU
Last Name:PINEDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 ROUTE 70
Mailing Address - Street 2:
Mailing Address - City:LAKEHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:08733-2853
Mailing Address - Country:US
Mailing Address - Phone:732-657-8111
Mailing Address - Fax:732-657-7828
Practice Address - Street 1:681 ROUTE 70
Practice Address - Street 2:
Practice Address - City:LAKEHURST
Practice Address - State:NJ
Practice Address - Zip Code:08733-2853
Practice Address - Country:US
Practice Address - Phone:732-657-8111
Practice Address - Fax:732-657-7828
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA064187207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG35423Medicare UPIN
NJ891337Medicare ID - Type Unspecified