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General NPI Number Information
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NPI Number | 1811715386
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Entity Type | Organization
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Legal Business Name | PREMIER CHOICE MEDICAL
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 811 CLIFTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07013-1872
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Country | US
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Telephone | 973-928-4004
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 820
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City | WEST MILFORD
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State | NJ
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Zip | 07480-0820
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Country | US
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Telephone | 973-214-4935
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAUL BABITZ
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Credential | APN, DC
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Telephone | 973-214-4935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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