Organization
PRIME MED MEDICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRABASH KONERU MD (MEDICAL DIRECTOR)
(347) 276-8866
Entity
Organization
Contact information
Practice address
1676 N OLDEN AVE, EWING, NJ 08638-3209
(347) 276-8866
Mailing address
2114 PACIFIC BLVD, ATLANTIC BEACH, NY 11509-1139
(347) 276-8866
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NJ
Other
Enumeration date
04/02/2018
Last updated
04/02/2018
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