Organization
PEMBERTON M.D P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLIN A PEMBERTON M.D (/OWNER)
(973) 844-3188
Entity
Organization
Contact information
Practice address
500 ORANGE ST, NEWARK, NJ 07107-2944
(973) 844-3188
Mailing address
500 ORANGE ST, NEWARK, NJ 07107-2944
(973) 844-3188
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0198323
—
NJ
Enumeration date
05/11/2017
Last updated
05/11/2017
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