| Organization Name: | PRONERVE PHYSICIANS NJ LLC |
| NPI Number: | 1235478520 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GEORGE D PILLARI (CEO) |
| Mailing Address: | 7600 E Orchard Rd 200n Greenwood Village |
| State: | CO US |
| Postal Code: | 801112520 |
| Phone Number: | 3033391499 |
| Fax Number: | 3039624819 |
| NPI Enumeration Date: | 02/06/2013 |
| NPI Last Update Date: | 01/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 25MA08855500 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |