Provider Demographics
NPI:1255011656
Name:PRM GYNECOLOGY OF MARYLAND PC
Entity type:Organization
Organization Name:PRM GYNECOLOGY OF MARYLAND PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR RCM
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGNESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-422-4206
Mailing Address - Street 1:2090 PALM BEACH LAKES BLVD STE 700
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6508
Mailing Address - Country:US
Mailing Address - Phone:561-422-4206
Mailing Address - Fax:
Practice Address - Street 1:6410 ROCKLEDGE DR STE 210
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1830
Practice Address - Country:US
Practice Address - Phone:301-941-4004
Practice Address - Fax:561-318-0134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty