| NPI | 1437856648 |
|---|---|
| Doing Business As | PRODIGY AESTHETICS AND PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | CAROLYN CEDENO Owner 973-221-5527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2023-02-08 |
| Last Update Date | 2023-03-08 |