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Organization

PRIME CARE PHYSICIANS, P.L.L.C.

Active
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Organization

PRIME CARE PHYSICIANS, P.L.L.C.

Active
Other names
Prime Care Physicians, P.L.L.C.
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL WHALEN (DIRECTOR OF ADMINISTRATION)
(518) 435-2704
Entity
Organization

Contact information

Practice address
582 NEW LOUDON RD, LATHAM, NY 12110-4029
(518) 783-0072
(518) 783-8138
Mailing address
4 ATRIUM DR, SUITE 100, ALBANY, NY 12205-1441
(518) 435-2704
(518) 458-2610

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
54964
NY
207RH0000X
Hematology (Internal Medicine) Physician
54964
NY
363AM0700X
Medical Physician Assistant
54964
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02616571
—
NY
Enumeration date
05/01/2007
Last updated
03/28/2012
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