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Organization
PRIMECARE FAMILY MEDICINE
Active
Organization
PRIMECARE FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOROTHEA KELLIGREW (MEDICAL BILLING MANAGER)
(914) 631-3640
Entity
Organization
Contact information
Practice address
20 BEACON HILL DR STE 2B, DOBBS FERRY, NY 10522-2402
(914) 591-6888
(914) 591-7938
Mailing address
20 BEACON HILL DR STE 2B, DOBBS FERRY, NY 10522-2402
(914) 591-6888
(914) 591-7938
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
204658
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01694682
—
NY
01
—
66760
BLUE CROSS BLUE SHIELD
NY
01
—
OD1520
HEALTHNET
NY
01
—
P620018
OXFORD
NY
Enumeration date
07/30/2006
Last updated
08/22/2020
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