Provider Demographics
NPI:1487356721
Name:PROSPER DIGITAL THERAPEUTICS, INC
Entity type:Organization
Organization Name:PROSPER DIGITAL THERAPEUTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMMERCIAL OFFIER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-216-5731
Mailing Address - Street 1:44 SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-2521
Mailing Address - Country:US
Mailing Address - Phone:862-216-5731
Mailing Address - Fax:
Practice Address - Street 1:44 SHERWOOD RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-2521
Practice Address - Country:US
Practice Address - Phone:862-216-5731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management