Organization
PRECIOUS LIFE MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FARDOSE RANA MSC, RDMS (OWNER)
(732) 444-4646
Entity
Organization
Contact information
Practice address
1030 SAINT GEORGES AVE STE 200A, AVENEL, NJ 07001-1330
(732) 444-4646
Mailing address
1030 SAINT GEORGES AVE STE 200A, AVENEL, NJ 07001-1330
(732) 444-4646
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0886432
—
NJ
Enumeration date
05/31/2021
Last updated
02/01/2023
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