KATHLEEN MARY PRENDERGAST (NPI# 1669498846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669498846 |
| Entity Type | Individual |
| Full Name | KATHLEEN MARY PRENDERGAST |
| Credential | APN |
| Practice Address |
60 S Fullerton Ave Ste 210 Montclair NJ 07042-2663 |
| Mailing Address |
47 Washburn Pl Caldwell NJ 07006-5917 |
| Practice Telephone | 9737446522 |
| Practice Fax Number | 9737446362 |
| Mailing Telephone | 9732281740 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
26NJ00108400 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649260753 | Kathleen Prendergast | Internal Medicine | 300 Hospital Dr, Suite 119, Glen Burnie, MD 21061-6902 | 2005-10-28 |
| 1750940961 | Kathleen Prendergast | Optometrist | 5865 W Utopia Rd, Glendale, AZ 85308-5251 | 2019-06-11 |
| 1003003377 | Kathleen Prendergast | Massage Therapist | 210 E Main St, Springville, NY 14141-1442 | 2007-10-01 |
| 1417072810 | Kathleen E Prendergast | Counselor | 227 E Main St, Festus, MO 63028-1952 | 2007-03-21 |
| Street Address |
60 S FULLERTON AVE STE 210 |
| City | MONTCLAIR |
| State | NJ |
| Zip Code | 07042-2663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790154763 | Sara Kate Fagan | Social Worker | 60 S Fullerton Ave Ste 210, Montclair, NJ 07042-2663 | 2015-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003451261 | Montclair Art Museum | Voluntary or Charitable | 3 South Mountain Avenue, Montclair, NJ 07042 | 2019-11-12 |
| 1740847797 | Magnify In-home Eyecare | Optometrist | Little Nursing Home, 71 Christopher Street, Montclair, NJ 07042 | 2019-05-24 |
| 1326539073 | Wendy C Kaplan | Social Worker | 460 Bloomfield Ave Suite 209, Montclair, NJ 07042 | 2018-05-29 |
| 1538666342 | Mary Elizabeth Mcgaughan | Psychologist | 239 Grove Street, Montclair, NJ 07042 | 2018-04-09 |
| 1023546777 | Alexander Scott Fisher | Dentist | 39 S Fullerton Ave Fl 2, Montclair, NJ 07042 | 2017-05-25 |
| 1942754825 | Kaity Rodriguez | Social Worker | 105 Grove St., Montclair, NJ 07042 | 2016-08-09 |
| 1144678889 | Melissa Cardinal | Nurse Practitioner | 36 Valley Road, 529, Montclair, NJ 07042 | 2016-06-02 |
| 1528413655 | Bellapianta Orthopaedics and Sports Medicine LLC | Orthopaedic Surgery | 1 Bay Avenue, Harries Pavilion, Suite 1, Montclair, NJ 07042 | 2016-04-26 |
| 1740647643 | Wendalyn Leona Browne | Massage Therapist | 37 Watchung Plaza, 2l, Montclair, NJ 07042 | 2016-01-22 |
| 1891168670 | Patience Moore | Social Worker | 460 Bloomfield Ave Ste 306, Montclair, NJ 07042 | 2015-11-03 |
| Find all providers in zip 07042 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457991986 | Christopher Hannon | Nurse Practitioner | 16 Seymour St Apt 2, Montclair, NJ 07042-3356 | 2020-01-13 |
| 1144678889 | Melissa Cardinal | Nurse Practitioner | 36 Valley Road, 529, Montclair, NJ 07042 | 2016-06-02 |
| 1003473646 | Recovery & Wellness Center, LLC. | Nurse Practitioner | 218 Lorraine Ave, Montclair, NJ 07043-1915 | 2019-05-20 |
| 1649703299 | Linda Winful | Nurse Practitioner | 51 Cedar Ave, Montclair, NJ 07042-2446 | 2017-04-10 |
| 1548616840 | Absolutely Driven Mental Health Provider LLC | Nurse Practitioner | 100 Valley Rd, Suite1, Montclair, NJ 07042-2200 | 2016-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699943 | Ernest Akwaboah | Nurse Practitioner | 87 Burnett Ave, Maplewood, NJ 07040-3094 | 2020-11-04 |
| 1548861081 | Temitope Akande | Nurse Practitioner | 557 Liberty St, Orange, NJ 07050-1275 | 2020-11-02 |
| 1538767587 | Ruth Yamoah-cofie | Nurse Practitioner | 1160 E 7th St, Plainfield, NJ 07062-1906 | 2020-10-13 |
| 1336756170 | Jacqueline Michele Arnone | Nurse Practitioner | 105 Windward Dr, Manahawkin, NJ 08050-3345 | 2020-09-25 |
| 1750997789 | Eunice Ramos | Nurse Practitioner | 300-a Forest Avenue, Paramus, NJ 07652 | 2020-09-15 |
| 1174138952 | Darlene Lupo | Nurse Practitioner | 72 Morris Ave, Neptune, NJ 07753 | 2020-09-09 |
| 1841804960 | Claudette L Blake | Nurse Practitioner | 890 Terrill Rd, Plainfield, NJ 07062-2250 | 2020-09-04 |
| 1982217873 | Ifeoma E Iherobiem | Nurse Practitioner | 884 S Springfield Ave Apt 18, Springfield, NJ 07081-3320 | 2020-08-28 |
| 1871106088 | Firmin Langyin | Nurse Practitioner | 200 Station Dr Apt 207, Avenel, NJ 07001-1793 | 2020-08-26 |
| 1205448859 | Yanick E Jean | Nurse Practitioner | 32 Deerfield Dr, West Orange, NJ 07052-3627 | 2020-08-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.