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General NPI Number Information
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NPI Number | 1174672240
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Entity Type | Organization
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Legal Business Name | PREMIER MEDICAL ASSOCIATE PC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 10/03/2008
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Provider Practice Location Address
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Address Line | 1873 PATTERSON AVE
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City | BRONX
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State | NY
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Zip | 10473-3039
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Country | US
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Telephone | 718-589-2799
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Fax | 718-328-6839
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Provider Business Mailing Address
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Address Line | 1873 PATTERSON AVE
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City | BRONX
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State | NY
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Zip | 10473-3039
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Country | US
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Telephone | 718-589-2799
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Fax | 718-328-6839
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HITESH BABUBHAI PATEL
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Credential | MD
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Telephone | 718-589-2799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 236025
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License Number State | NY
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