MEDICARE: PRIME PULSE MEDICAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261Q00000X	Clinic/Center
2	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center
3	261QM2500X	Medical Specialty Clinic/Center
4	261QR1100X	Research Clinic/Center
5	261QU0200X	Urgent Care Clinic/Center
6	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1790619716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME PULSE MEDICAL LLC

Provider Business Mailing Address
First Line	:	21 COOPER ST
Second Line	:
City	:	BAYONNE
State	:	NJ
Zip	:	07002-4411
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	840 BERGEN AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-4507
Country	:	US
Telephone Number	:	551-314-4600
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	DR. MARIAN MICHAL
Credential	:	MD
Telephone Number	:	551-241-9255

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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Directions to “PRIME PULSE MEDICAL LLC ” Practice Location

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