| Prospect Medical Office, Llc | |
|
301 Godwin Ave Midland Park NJ 07432-1544 | |
| (201) 444-4526 | |
| (201) 689-0638 |
| Full Name | Prospect Medical Office, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 301 Godwin Ave, Midland Park, New Jersey |
| Authorized Official Name and Position | Susan Terek (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 2014444530 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prospect Medical Office, Llc 301 Godwin Ave Midland Park NJ 07432-1544 Ph: (201) 444-4526 | Prospect Medical Office, Llc 301 Godwin Ave Midland Park NJ 07432-1544 Ph: (201) 444-4526 |
| NPI Number | 1609956556 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 12/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609956556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (New Jersey) | Primary |
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