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Organization
PRIME CARE PHYSICIANS, P.L.L.C.
Active
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
1444 WESTERN AVE, SUITE B-1, ALBANY, NY 12203-3440
(518) 458-2611
(518) 489-1914
Mailing address
4 ATRIUM DR, SUITE 100, ALBANY, NY 12205-1441
(518) 435-2704
(518) 458-2610
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
54964
NY
207QA0401X
Addiction Medicine (Family Medicine) Physician
54964
NY
207R00000X
Internal Medicine Physician
54964
NY
363LA2200X
Adult Health Nurse Practitioner
54964
NY
363LF0000X
Family Nurse Practitioner
54964
NY
363LG0600X
Gerontology Nurse Practitioner
54964
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02616571
—
NY
Enumeration date
04/26/2007
Last updated
03/28/2012
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