Provider Demographics
NPI:1427091552
Name:POBLETE, HONESTO NAZARENO (MD)
Entity type:Individual
Prefix:DR
First Name:HONESTO
Middle Name:NAZARENO
Last Name:POBLETE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1601 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3821
Mailing Address - Country:US
Mailing Address - Phone:609-586-1313
Mailing Address - Fax:609-584-9227
Practice Address - Street 1:1601 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3821
Practice Address - Country:US
Practice Address - Phone:609-586-1313
Practice Address - Fax:609-584-9227
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2014-07-30
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Provider Licenses
StateLicense IDTaxonomies
NJ28176208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2806606Medicaid
NJC60719Medicare UPIN
NJ2806606Medicaid