| Prudentmd LLC | |
|
5 Dundee Avenue Iselin NJ 08830-2118 | |
| (732) 404-0044 | |
| (800) 310-0849 |
| Full Name | Prudentmd LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 5 Dundee Avenue, Iselin, New Jersey |
| Authorized Official Name and Position | Maitri Patel (PHYSICIAN OWNER) |
| Authorized Official Contact | 7324040044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prudentmd LLC 5 Dundee Avenue Iselin NJ 08830-2118 Ph: (732) 404-0044 | Prudentmd LLC 5 Dundee Avenue Iselin NJ 08830-2118 Ph: (732) 404-0044 |
| NPI Number | 1457524217 |
|---|---|
| Provider Enumeration Date | 04/11/2008 |
| Last Update Date | 09/26/2008 |
| Medicare PECOS PAC ID | 4789750852 |
|---|---|
| Medicare Enrollment ID | O20080915000202 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457524217 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 25MA08134000 (New Jersey) | Primary |
| Provider Name | Maitri Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043398076 PECOS PAC ID: 2567553316 Enrollment ID: I20070808000224 |
| Provider Name | Anneta V Golubchik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861511610 PECOS PAC ID: 7618166448 Enrollment ID: I20110111000119 |
| Provider Name | Jessica Benjamin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992439251 PECOS PAC ID: 0941679252 Enrollment ID: I20221208001408 |
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