Provider Demographics
NPI:1932265535
Name:PRUDENT MEDICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:PRUDENT MEDICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BATRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-548-2500
Mailing Address - Street 1:220 BRIDGE ST
Mailing Address - Street 2:BUILDING E
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2291
Mailing Address - Country:US
Mailing Address - Phone:732-548-2500
Mailing Address - Fax:732-549-7070
Practice Address - Street 1:220 BRIDGE ST
Practice Address - Street 2:BUILDING E
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2291
Practice Address - Country:US
Practice Address - Phone:732-548-2500
Practice Address - Fax:732-549-7070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04114600207RN0300X
NJ25MA04114500208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ051165Medicare ID - Type Unspecified