Organization
PROSPERO MEDICAL SERVICES NEW JERSEY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY K MANN (CREDENTIALING MANAGER)
(901) 422-7608
Entity
Organization
Contact information
Practice address
1 GATEWAY CTR STE 2600, NEWARK, NJ 07102-5323
(866) 949-0108
Mailing address
50 S B B KING BLVD, MEMPHIS, TN 38103-2626
(901) 422-7644
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
12/04/2019
Last updated
12/27/2021
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