Provider Demographics
NPI:1043461692
Name:PREMIER MEDICAL HEALTHCARE P.C.
Entity Type:Organization
Organization Name:PREMIER MEDICAL HEALTHCARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:FRIAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-348-9501
Mailing Address - Street 1:282 ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:CENTRAL NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960
Mailing Address - Country:US
Mailing Address - Phone:845-348-9501
Mailing Address - Fax:845-348-9384
Practice Address - Street 1:282 ROUTE 59
Practice Address - Street 2:
Practice Address - City:CENTRAL NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960
Practice Address - Country:US
Practice Address - Phone:845-348-9501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty