MEDICARE: PRESTIGE EDUCATIONAL MANAGEMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center		NJ

General Provider Information

NPI Number	:	1730353764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESTIGE EDUCATIONAL MANAGEMENT

Provider Business Mailing Address
First Line	:	4313 ROUTE 130
Second Line	:	SUITE B-5
City	:	EDGEWATER PARK
State	:	NJ
Zip	:	08010-3109
Country	:	US
Telephone Number	:	609-531-0128
Fax Number	:	609-877-8602

Provider Business Practice Location Address
First Line	:	4313 ROUTE 130
Second Line	:	SUITE B-5
City	:	EDGEWATER PARK
State	:	NJ
Zip	:	08010-3109
Country	:	US
Telephone Number	:	609-531-0128
Fax Number	:	609-877-8602

Authorized Official
Title or Position	:	OWNER
Name	:	MS. DANA KEARNEY
Credential	:	DON
Telephone Number	:	856-264-0374

Provider Enumeration Date	:	04/22/2008
Last Update Date	:	04/22/2008

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Directions to “PRESTIGE EDUCATIONAL MANAGEMENT ” Practice Location

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