Individual
KATHLEEN MANGUNAY PERGAMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O., M.P.H.
Contact information
Practice address
90 BERGEN ST STE 4400, NEWARK, NJ 07103-2425
(973) 972-1880
(973) 972-1879
Mailing address
185 SOUTH ORANGE MSB, ROOM I-506,, RUTGERS, NEW JERSEY MEDICAL SCHOOL, DEPT OF MEDICINE, NEWARK, NJ 07103
(973) 972-5672
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MB09641000
NJ
207R00000X
Internal Medicine Physician
265560-1
NY
Other
Enumeration date
08/15/2010
Last updated
08/07/2015
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