# PREMIER SHORE MEDICAL LLC

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

## Provider details

- **NPI number:** 1497229520
- **Authorized official:** JASON NEHMAD MD (OWNER)
- **Authorized official phone:** (917) 406-8696

## Contact information

- **Practice address:** 2621 HWY 138, WALL TOWNSHIP, NJ 07719-9660
- **Practice address phone:** (732) 556-1060
- **Mailing address:** PO BOX 101, W LONG BRANCH, NJ 07764-0101

## Taxonomy

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

## Other

- **Enumeration date:** 01/11/2019
- **Last updated:** 01/11/2019