Provider Demographics
NPI:1447417522
Name:PINEDA, DANIELLE MARIE (MD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIE
Last Name:PINEDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 W JIMMIE LEEDS RD FL 1
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NJ
Mailing Address - Zip Code:08240-9102
Mailing Address - Country:US
Mailing Address - Phone:609-748-7089
Mailing Address - Fax:609-652-3460
Practice Address - Street 1:65 W JIMMIE LEEDS RD FL 1
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NJ
Practice Address - Zip Code:08240-9102
Practice Address - Country:US
Practice Address - Phone:609-748-7089
Practice Address - Fax:609-652-3460
Is Sole Proprietor?:No
Enumeration Date:2008-05-17
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT192343208600000X
PAMD4434182086S0129X
NJ25MA125070002086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery