Individual
THOMAS W PRENDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2005 FAIRVIEW AVE, SUITE A, EASTON, PA 18042-3915
(610) 923-5200
(610) 923-5272
Mailing address
2005 FAIRVIEW AVE, SUITE A, EASTON, PA 18042-3915
(610) 923-5200
(610) 923-5272
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
25MA06864200
NJ
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
2015010868
MO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
25MA06864200
NJ
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD064702L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7496303
—
NJ
01
—
P007151069
RR MCR
NJ
Enumeration date
07/25/2006
Last updated
09/20/2016
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