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General NPI Number Information
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NPI Number | 1659844884
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Entity Type | Organization
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Legal Business Name | PRIME MD, PC
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Dates
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Enumeration Date | 01/10/2019
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Last Update Date | 01/10/2019
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Provider Practice Location Address
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Address Line | 115 ROUTE 206
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City | CHESTER
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State | NJ
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Zip | 07930
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Country | US
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Telephone | 352-207-4949
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Fax | 201-304-0606
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Provider Business Mailing Address
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Address Line | 300 MAIN ST # 765
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City | MADISON
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State | NJ
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Zip | 07940-2369
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Country | US
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Telephone | 352-361-0622
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SANJAY ASHWIN PATEL
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Credential | MD
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Telephone | 352-361-0622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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