PRODIGY AESTHETICS AND PRIMARY CARE
NPI 1437856648
Nurse Practitioner - Primary Care in Paterson, NJ

Q: What is Prodigy Aesthetics's NPI number?

The NPI number for Prodigy Aesthetics is 1437856648. It was assigned to this organization in the NPPES registry on February 8, 2023. The provider is doing business as Prodigy Aesthetics And Primary Care.

Q: What is Prodigy Aesthetics's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Active since February 08, 2023CLIA 31D2276707 · Waiver

680 BROADWAY STE 205, PATERSON, NJ 07514(973) 790-0123 Get Directions Write a Review

NPPES record last updated: March 8, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 8, 2023, Feb 9, 2023 (2 updates tracked since 2023).

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About Prodigy Aesthetics And Primary Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRODIGY AESTHETICS AND PRIMARY CARE (NPI 1437856648) is a healthcare organization registered as a primary care in Paterson, New Jersey and active in the NPI registry since February 2023. The organization holds a CLIA Waiver certificate valid through February 13, 2027 and lists Carolyn Cedeno, Owner, as its authorized official.

NPPES Registry Identity

NPI1437856648

Entity TypeOrganization

Primary Taxonomy363LP2300X

Legal Business NamePRODIGY AESTHETICS

Location Address680 BROADWAY STE 205Paterson, NJ 07514-1527

Mailing Address680 Broadway Ste 205Paterson, NJ 07514-1527 · (973) 790-0123

Phone(973) 790-0123

Organization SubpartNo

Authorized OfficialCarolyn CedenoOwner · (973) 221-5527

Enumeration DateFebruary 8, 2023

Last NPPES UpdateMarch 8, 20232 updates tracked since enumeration

NPPES CertifiedMarch 8, 2023

✔ NPI 1437856648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

680 BROADWAY STE 205, Paterson, NJ 07514

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Other Names 1

Doing Business AsProdigy Aesthetics And Primary Care

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D2276707

Prodigy Aesthetics And Primary Care · Paterson, NJ

Active · expires Feb 13, 2027

CLIA Number31D2276707

Laboratory TypePractitioner Other

Certificate Effective DateFebruary 14, 2025

Certificate Expiration DateFebruary 13, 2027

Laboratory DirectorCarolyn Cedeno

Laboratory Phone(973) 221-5527

Laboratory LocationProdigy Aesthetics And Primary Care680 Broadway Suite 205, Paterson, NJ 07514

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRC SUPPLIES INC

Durable Medical Equipment & Medical Supplies

680 BROADWAY STE 205
PATERSON, NJ 07514

Passaic County (917) 450-4527

MD HEALTH GROUP LLC

Surgery (Vascular Surgery)

680 BROADWAY STE 205
PATERSON, NJ 07514

Passaic County (201) 839-3834

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prodigy Aesthetics's NPI number?

The NPI number for Prodigy Aesthetics is 1437856648. It was assigned to this organization in the NPPES registry on February 8, 2023. The provider is doing business as Prodigy Aesthetics And Primary Care.

Where is Prodigy Aesthetics located?

Prodigy Aesthetics is located at 680 Broadway Ste 205, Paterson, NJ 07514. The listed phone number is (973) 790-0123.

What is Prodigy Aesthetics's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Does Prodigy Aesthetics hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2276707) is associated with this NPI, valid through February 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Prodigy Aesthetics was last updated on March 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.