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General NPI Number Information
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NPI Number | 1194028092
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Entity Type | Organization
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Legal Business Name | PREMISE HEALTH OF NEW JERSEY MEDICAL, P.C
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Dates
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Enumeration Date | 12/15/2010
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 100 MORRIS ST RM 2-018
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City | MORRISTOWN
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State | NJ
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Zip | 07960-4563
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Country | US
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Telephone | 908-981-6925
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Fax | 908-306-9010
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Provider Business Mailing Address
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Address Line | 5500 MARYLAND WAY
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City | BRENTWOOD
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State | TN
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Zip | 37027-4948
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Country | US
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Telephone | 888-830-4255
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JON B LEIZMAN
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Credential | M.D.
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Telephone | 216-479-9063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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