Individual
KATHLEEN MARY PRENDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
60 S FULLERTON AVE STE 210, MONTCLAIR, NJ 07042-2663
(973) 744-6522
(973) 744-6362
Mailing address
47 WASHBURN PL, CALDWELL, NJ 07006-5917
(973) 228-1740
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00108400
NJ
Other
Enumeration date
07/14/2006
Last updated
07/08/2007
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