Provider Demographics
NPI:1942785324
Name:PRECIOUS MEDICAL CARE LLC
Entity Type:Organization
Organization Name:PRECIOUS MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:FEHINTOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNSAKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-939-5885
Mailing Address - Street 1:7 SELMA LN
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-2475
Mailing Address - Country:US
Mailing Address - Phone:732-939-5885
Mailing Address - Fax:
Practice Address - Street 1:288 N BROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-3711
Practice Address - Country:US
Practice Address - Phone:732-503-3063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty