Prospect Medical Office, LLC

NPI #1316198922 in Midland Park, New Jersey

Provider Information

NPI Number
1316198922
Entity Type
Organization
Organization Name
Prospect Medical Office, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
PROSPECT MEDICAL OFFICE, LLC
Primary Specialty
Specialist
Enumeration Date
Oct 2, 2008
Last Updated
Oct 2, 2008

Practice Location

Address
301 GODWIN AVE
ZIP Code
07432-1544
Phone
(201) 444-4526

Authorized Official

Name
BENNETT P LEIFER, M.D.
Title
MANAGING PHYSICIAN
Phone
(201) 444-4526

Specialties & Taxonomy Codes

Specialty
Specialist

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