# PRIME MED MEDICAL SERVICES PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205332111
- **Authorized official:** DR. PRABASH KONERU MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (347) 276-8866

## Contact information

- **Practice address:** 1676 N OLDEN AVE, EWING, NJ 08638-3209
- **Practice address phone:** (347) 276-8866
- **Mailing address:** 2114 PACIFIC BLVD, ATLANTIC BEACH, NY 11509-1139
- **Mailing address phone:** (347) 276-8866

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NJ | Yes |

## Other

- **Enumeration date:** 04/02/2018
- **Last updated:** 04/02/2018