Provider Demographics
NPI:1568092476
Name:PREMIER MEDICAL LLC
Entity Type:Organization
Organization Name:PREMIER MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOJDANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-813-3117
Mailing Address - Street 1:91 FAIRHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 FOXBOROUGH BLVD APT 4208
Practice Address - Street 2:
Practice Address - City:FOXBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:02035-3807
Practice Address - Country:US
Practice Address - Phone:443-813-3117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-20
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty