Provider Demographics
NPI:1821088592
Name:PRISTAS, ADRIAN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:MICHAEL
Last Name:PRISTAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:972 STATE ROUTE 36
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1700
Mailing Address - Country:US
Mailing Address - Phone:732-847-3600
Mailing Address - Fax:732-847-3602
Practice Address - Street 1:972 STATE ROUTE 36
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1700
Practice Address - Country:US
Practice Address - Phone:732-847-3600
Practice Address - Fax:732-847-3602
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA58104207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5250901Medicaid
NJF33432Medicare UPIN
NJ048329Medicare ID - Type Unspecified