Provider Demographics
NPI:1790535169
Name:PRIMA MED MEDICAL & HEADACHE CENTER LLC
Entity Type:Organization
Organization Name:PRIMA MED MEDICAL & HEADACHE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAZAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ASAAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-756-7785
Mailing Address - Street 1:1336 ASHLEY LN
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-9752
Mailing Address - Country:US
Mailing Address - Phone:610-756-7785
Mailing Address - Fax:
Practice Address - Street 1:1336 ASHLEY LN
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-9752
Practice Address - Country:US
Practice Address - Phone:610-756-7785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-26
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Multi-Specialty
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity MedicineGroup - Multi-Specialty