Organization
PROSPECT MEDICAL OFFICE, LLC
Active
Parent organization
PROSPECT MEDICAL OFFICE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROSPECT MEDICAL OFFICE, LLC
Authorized official
BENNETT P LEIFER M.D. (MANAGING PHYSICIAN)
(201) 444-4526
Entity
Organization
Contact information
Practice address
301 GODWIN AVE, MIDLAND PARK, NJ 07432-1544
(201) 444-4526
(201) 689-0638
Mailing address
301 GODWIN AVE, MIDLAND PARK, NJ 07432-1544
(201) 444-4526
(201) 689-0638
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/02/2008
Last updated
10/02/2008
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