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Organization
PRIMARY HEALTH OF NORTHERN NEW YORK, PLLC
Active
Organization
PRIMARY HEALTH OF NORTHERN NEW YORK, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH A THURHEIMER MD (OWNER AND ORIGINAL MEMBER)
(315) 782-7550
Entity
Organization
Contact information
Practice address
156 CLINTON ST, WATERTOWN, NY 13601-3602
(315) 782-7550
Mailing address
156 CLINTON ST, WATERTOWN, NY 13601-3602
(315) 782-7550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
210993
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01862091
—
NY
01
—
142658XX
PREFERRED CARE
NY
01
—
5996936
GHI PROVIDER ID
NY
01
—
711552
MVP PROVIDER ID
NY
01
—
DB0031
GRP # PALMETTO RR MCR
NY
01
—
P00082023
PALMETTO RR MEDICARE
NY
Enumeration date
03/14/2007
Last updated
08/22/2020
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