Provider Demographics
NPI:1316365158
Name:PEDOWITZ, LAURA (PA-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:PEDOWITZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 TAYLORS MILLS RD
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3281
Mailing Address - Country:US
Mailing Address - Phone:732-847-9910
Mailing Address - Fax:609-443-8070
Practice Address - Street 1:224 TAYLORS MILLS RD
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3281
Practice Address - Country:US
Practice Address - Phone:732-847-9910
Practice Address - Fax:609-443-8070
Is Sole Proprietor?:No
Enumeration Date:2014-03-29
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant