Provider Demographics
NPI:1942367818
Name:SPRONK, GINGER L (MPAS, PA-C)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:L
Last Name:SPRONK
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 SCULLY CT
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-4235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:310 STATE ROUTE 24
Practice Address - Street 2:SUITE B-1A
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2625
Practice Address - Country:US
Practice Address - Phone:908-879-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00169800363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant