Individual
MR. VINCENT JAMES PRENDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 426-5622
(508) 421-1085
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN266879
MA
Other
Enumeration date
06/02/2009
Last updated
11/25/2020
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