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Individual

DR. JONATHAN L PRENNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10 PLUM STREET, SUITE 600, NEW BRUNSWICK, NJ 08901
(732) 220-1600
(732) 220-1603
Mailing address
1000 GALLOPING HILL RD STE 305, UNION, NJ 07083-7991
(908) 458-8333
(908) 458-8339

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
25MA07734200
NJ
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
25MA07110100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0097641
NJ
Enumeration date
02/10/2006
Last updated
08/04/2017
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