Provider Demographics
NPI:1215048871
Name:PARRENO, MARITZA GEORGETTE (MD)
Entity type:Individual
Prefix:DR
First Name:MARITZA
Middle Name:GEORGETTE
Last Name:PARRENO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:200 PERRINE RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-2842
Mailing Address - Country:US
Mailing Address - Phone:732-721-1600
Mailing Address - Fax:732-721-1635
Practice Address - Street 1:200 PERRINE RD
Practice Address - Street 2:SUITE 220
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-2842
Practice Address - Country:US
Practice Address - Phone:732-721-1600
Practice Address - Fax:732-721-1635
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA064987207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7827202Medicaid
NJG66798Medicare UPIN
NJ021817Medicare ID - Type Unspecified