Provider Demographics
NPI:1588118046
Name:PRISM MEDICAL ASSOCIATES,LLC
Entity type:Organization
Organization Name:PRISM MEDICAL ASSOCIATES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ARSHAD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:774-413-0976
Mailing Address - Street 1:1421 ORLEANS RD
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-2148
Mailing Address - Country:US
Mailing Address - Phone:508-430-1220
Mailing Address - Fax:508-430-5029
Practice Address - Street 1:1421 ORLEANS RD
Practice Address - Street 2:
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645-2148
Practice Address - Country:US
Practice Address - Phone:508-430-1220
Practice Address - Fax:508-430-5029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-12
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA234328261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service