Organization
PRODIGY AESTHETICS
Active
Other names
Prodigy Aesthetics and Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN CEDENO APRN (OWNER)
(973) 221-5527
Entity
Organization
Contact information
Practice address
680 BROADWAY STE 205, PATERSON, NJ 07514-1527
(973) 790-0123
Mailing address
680 BROADWAY STE 205, PATERSON, NJ 07514-1527
(973) 790-0123
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/08/2023
Last updated
03/08/2023
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