Provider Demographics
NPI:1043469943
Name:PREMIER PHYSICIANS AND SURGEONS, PLLC
Entity Type:Organization
Organization Name:PREMIER PHYSICIANS AND SURGEONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOSCATELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-372-7003
Mailing Address - Street 1:PO BOX 488
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-0488
Mailing Address - Country:US
Mailing Address - Phone:914-372-7003
Mailing Address - Fax:914-372-7013
Practice Address - Street 1:1055 SAW MILL RIVER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-1045
Practice Address - Country:US
Practice Address - Phone:914-693-7636
Practice Address - Fax:914-693-5994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty