Provider Demographics
NPI:1912939844
Name:PEDRA-NOBRE, MANUELA G (MD)
Entity type:Individual
Prefix:DR
First Name:MANUELA
Middle Name:G
Last Name:PEDRA-NOBRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4606
Mailing Address - Street 2:NORTH JERSEY RHEUMATOLOGY CENTER PA
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059
Mailing Address - Country:US
Mailing Address - Phone:908-233-9111
Mailing Address - Fax:908-233-9920
Practice Address - Street 1:577 WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-3373
Practice Address - Country:US
Practice Address - Phone:908-233-9111
Practice Address - Fax:908-233-9920
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2011-05-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05738900207RR0500X
NJMA57389207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMA57389OtherLICENSE
NJ6594603Medicaid
NJMA57389OtherLICENSE
NJG14496Medicare UPIN
G14496Medicare UPIN