Healthcare Provider Details

I. General information

NPI: 1942367818
Provider Name (Legal Business Name): GINGER L SPRONK MPAS, PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 STATE ROUTE 24 SUITE B-1A
CHESTER NJ
07930-2625
US

IV. Provider business mailing address

124 SCULLY CT
BELLE MEAD NJ
08502-4235
US

V. Phone/Fax

Practice location:
  • Phone: 908-879-8800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00169800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: