Organization
PREMIER HEALTH ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MYCK (ADMINISTRATIVE ASSISTANT)
(973) 940-0423
Entity
Organization
Contact information
Practice address
123 NEWTON SPARTA RD, NEWTON, NJ 07860-2769
(973) 579-6300
(973) 579-1524
Mailing address
532 LAFAYETTE RD STE 300, SPARTA, NJ 07871-4411
(973) 940-0423
(973) 940-0399
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207RX0202X
Medical Oncology Physician
—
—
213E00000X
Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6747809
—
NJ
01
—
CA3072
NJ RAILROAD MEDICARE
NJ
01
—
CA6896
PA RAILROAD MEDICARE
PA
Enumeration date
05/31/2006
Last updated
11/29/2017
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