# SUSTACHE PRIMARY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336955954
- **Authorized official:** DR. GILBERTO SUSTACHE JR. MD (PHYSICIAN/OWNER)
- **Authorized official phone:** (832) 763-0833

## Contact information

- **Practice address:** 65 BOSTON POST RD W STE 100, MARLBOROUGH, MA 01752-1872
- **Practice address phone:** (508) 422-4844
- **Practice address fax:** (351) 202-1665
- **Mailing address:** 65 BOSTON POST RD W STE 100, MARLBOROUGH, MA 01752-1872
- **Mailing address phone:** (508) 422-4844
- **Mailing address fax:** (351) 202-1665

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/09/2024
- **Last updated:** 12/09/2024