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General NPI Number Information
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NPI Number | 1942925805
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Entity Type | Organization
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Legal Business Name | PROMETRIX HEALTH LLC
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Dates
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Enumeration Date | 10/04/2022
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 20927 KELLY RD STE 6
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City | EASTPOINTE
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State | MI
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Zip | 48021-3128
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Country | US
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Telephone | 313-733-8286
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Fax |
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Provider Business Mailing Address
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Address Line | 20927 KELLY RD STE 6
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City | EASTPOINTE
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State | MI
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Zip | 48021-3128
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Country | US
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Telephone | 313-733-8286
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | RIBHI HAZIN
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Credential | MD
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Telephone | 586-777-8801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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