Healthcare Provider Details

I. General information

NPI: 1326095480
Provider Name (Legal Business Name): JAMES A. PRATTA PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CARNIE BLVD
VOORHEES NJ
08043-1548
US

IV. Provider business mailing address

6301 BISHOPS VIEW CIR
CHERRY HILL NJ
08002-3458
US

V. Phone/Fax

Practice location:
  • Phone: 856-325-5060
  • Fax: 856-325-3197
Mailing address:
  • Phone: 215-518-3130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMP00097400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA051568
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: