Provider Demographics
NPI:1811715386
Name:PREMIER CHOICE MEDICAL
Entity type:Organization
Organization Name:PREMIER CHOICE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BABITZ
Authorized Official - Suffix:
Authorized Official - Credentials:APN, DC
Authorized Official - Phone:973-214-4935
Mailing Address - Street 1:PO BOX 820
Mailing Address - Street 2:
Mailing Address - City:WEST MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07480-0820
Mailing Address - Country:US
Mailing Address - Phone:973-214-4935
Mailing Address - Fax:
Practice Address - Street 1:811 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-1872
Practice Address - Country:US
Practice Address - Phone:973-928-4004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty