Provider Demographics
NPI:1487024121
Name:WEDIN, MARIA (PHD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:WEDIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2048 OAK TREE RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2012
Mailing Address - Country:US
Mailing Address - Phone:732-906-2669
Mailing Address - Fax:
Practice Address - Street 1:2048 OAK TREE RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2012
Practice Address - Country:US
Practice Address - Phone:732-906-2669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist