Provider Demographics
NPI:1639427495
Name:URGI-MED FAMILY MEDICAL CENTER
Entity Type:Organization
Organization Name:URGI-MED FAMILY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PREMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRASAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:973-891-1321
Mailing Address - Street 1:400 ROUTE 10 W
Mailing Address - Street 2:SUITE 1 AND 2
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2104
Mailing Address - Country:US
Mailing Address - Phone:973-891-1321
Mailing Address - Fax:973-206-5049
Practice Address - Street 1:400 ROUTE 10 W
Practice Address - Street 2:SUITE 1 AND 2
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-2104
Practice Address - Country:US
Practice Address - Phone:973-891-1321
Practice Address - Fax:973-206-5049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty