Provider Demographics
NPI:1053886424
Name:PREMIER MEDICAL HEALTH & WELLNESS LLC
Entity type:Organization
Organization Name:PREMIER MEDICAL HEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AVRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:NOYAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:908-839-8169
Mailing Address - Street 1:11 HOLDMAN PL
Mailing Address - Street 2:
Mailing Address - City:MILLSTONE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08535-9114
Mailing Address - Country:US
Mailing Address - Phone:908-839-8169
Mailing Address - Fax:
Practice Address - Street 1:11 HOLDMAN PL
Practice Address - Street 2:
Practice Address - City:MILLSTONE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08535-9114
Practice Address - Country:US
Practice Address - Phone:908-839-8169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty