Healthcare Provider Details

I. General information

NPI: 1972248623
Provider Name (Legal Business Name): DONALD PRATOLA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 S ORANGE AVE BLDG SUITEG
NEWARK NJ
07103-2757
US

IV. Provider business mailing address

185 S ORANGE AVE BLDG SUITEG
NEWARK NJ
07103-2757
US

V. Phone/Fax

Practice location:
  • Phone: 973-972-5018
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MB13121800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: