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Individual

FRED PRENDERGASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
355 GRAND ST, JERSEY CITY, NJ 07302-4321
(201) 915-2405
Mailing address
3998 FAIR RIDGE DR, SUITE 300, FAIRFAX, VA 22033-2907
(703) 295-9360
(703) 766-9725

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26NJ00212000
NJ
367500000X
Certified Registered Nurse Anesthetist
51286
NJ

Other

Enumeration date
07/01/2006
Last updated
03/19/2015
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