Healthcare Provider Details

I. General information

NPI: 1710757380
Provider Name (Legal Business Name): PREFERRED THERAPEUTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2024
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 ROUTE 31 N STE 2
ANNANDALE NJ
08801-3127
US

IV. Provider business mailing address

1322 ROUTE 31 N STE 2
ANNANDALE NJ
08801-3127
US

V. Phone/Fax

Practice location:
  • Phone: 908-894-7222
  • Fax: 908-894-7128
Mailing address:
  • Phone: 908-894-7222
  • Fax: 908-894-7128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MANISH B. VIRADIA
Title or Position: OWNER
Credential: MD
Phone: 908-240-2483