Provider Demographics
NPI:1043071830
Name:NJ PRIME HEALTH LLC
Entity type:Organization
Organization Name:NJ PRIME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANAN
Authorized Official - Middle Name:SNEHAL
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:848-238-0708
Mailing Address - Street 1:2038 FOX FIELD CIR
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-4600
Mailing Address - Country:US
Mailing Address - Phone:848-238-0708
Mailing Address - Fax:732-503-4703
Practice Address - Street 1:40 BEY LEA RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2989
Practice Address - Country:US
Practice Address - Phone:848-238-0708
Practice Address - Fax:732-503-4703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA11111000OtherMEDICAL LICENSE