Provider Demographics
NPI:1134952641
Name:BESTSELF PRIMARY CARE & MED SPA LLC
Entity type:Organization
Organization Name:BESTSELF PRIMARY CARE & MED SPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:PAVLI
Authorized Official - Middle Name:
Authorized Official - Last Name:ANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-560-9039
Mailing Address - Street 1:354 MERRIMACK ST STE 351
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1785
Mailing Address - Country:US
Mailing Address - Phone:978-560-9039
Mailing Address - Fax:
Practice Address - Street 1:354 MERRIMACK ST STE 351
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1785
Practice Address - Country:US
Practice Address - Phone:978-560-9039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care