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Organization
PREMIER MEDICAL, PLLC
Active
Organization
PREMIER MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFRY TAMBOR M.D. (MEDICAL DIRECTOR)
(718) 979-5880
Entity
Organization
Contact information
Practice address
265 MASON AVE, STATEN ISLAND, NY 10305-3412
(718) 979-5880
(718) 979-6476
Mailing address
PO BOX 141296, STATEN ISLAND, NY 10314-1296
(718) 979-5880
(718) 979-6476
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
158418
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01925915
—
NY
Enumeration date
11/07/2007
Last updated
11/02/2015
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