Healthcare Provider Details
I. General information
NPI: 1548973670
Provider Name (Legal Business Name): PRESTIGE MEDICAL SERVICES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/04/2023
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2100 WESCOTT DR
FLEMINGTON NJ
08822-4603
US
IV. Provider business mailing address
PO BOX 629
FRANKLIN LAKES NJ
07417-0629
US
V. Phone/Fax
- Phone: 201-847-8079
- Fax: 201-847-0059
- Phone: 201-847-8079
- Fax: 201-847-0059
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MINA
MOSAAD
Title or Position: PRESIDENT
Credential: DO
Phone: 908-300-3700