# PRIYALLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** d/b/a Primary family health clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396929931
- **Authorized official:** DR. ASHA RANI MITTAR I M.D. (PHYSCIAN/OWNER)
- **Authorized official phone:** (410) 719-9110

## Contact information

- **Practice address:** 7001 JOHNNYCAKE RD, SUITE\#200, BALTIMORE, MD 21244-2418
- **Practice address phone:** (410) 719-9110
- **Practice address fax:** (410) 719-9122
- **Mailing address:** 7001 JOHNNYCAKE RD, SUITE\#200, BALTIMORE, MD 21244-2418
- **Mailing address phone:** (410) 719-9110
- **Mailing address fax:** (410) 719-9122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | D45783 | MD | Yes |

## Other

- **Enumeration date:** 12/18/2007
- **Last updated:** 12/18/2007