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| Type | Legal entity | [sources] | |||
|---|---|---|---|---|---|
| Name | PEMBERTON, COLIN | [sources] | |||
| Legal form | not available | [sources] | |||
| Country | United States | [sources] | |||
| NPI | 1891935557 | [sources] | |||
| Sector | MD | [sources] | |||
| Status | not available | [sources] | |||
| Address | 2 DEVONSHIRE TERRACE, WEST ORANGE, NJ 07052 · 500 ORANGE STREET, NEWARK, NJ 07107 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers disqualified from participating in New Jersey State's Medicaid program.
United States of America · OIFP
us-mednj-926b196a727fc1bc477da5847cc1bef9b6997dbc · us-mednj-cbbcbe55d2ca70b8d98edfef5b2ba5ec2bf38713For experts: raw data explorer
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States | New Jersey Office of the State Comptroller | ||||
| Address | ||
|---|---|---|
| Full address | Country | |
| 500 ORANGE STREET, NEWARK, NJ 07107 | United States | |
| United States | New Jersey Office of the State Comptroller | - | - |
| 2 DEVONSHIRE TERRACE, WEST ORANGE, NJ 07052 | United States |