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Organization

PREMIER ONCOLOGY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAJASREE AJAY (PHYSICIAN)
(609) 748-1001
Entity
Organization

Contact information

Practice address
54 W JIMMIE LEEDS RD, SUITE 11, GALLOWAY, NJ 08205-9438
(609) 748-1001
(609) 748-1002
Mailing address
54 W JIMMIE LEEDS RD, SUITE 11, GALLOWAY, NJ 08205-9438
(609) 748-1001
(609) 748-1002

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
25MA07573400
NJ
332B00000X
Durable Medical Equipment & Medical Supplies
25MA07573400
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2864337000
AMERIHEALTH
NJ
01
DO2319
PALMETTO GBA-RAILROAD MEDICARE
NJ
01
G3827588
OXFORD
NJ
Enumeration date
07/31/2007
Last updated
10/22/2013
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