# PRIMARY HEALTH OF NORTHERN NEW YORK, PLLC

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

## Provider details

- **NPI number:** 1932232378
- **Authorized official:** DR. ELIZABETH A THURHEIMER MD (OWNER AND ORIGINAL MEMBER)
- **Authorized official phone:** (315) 782-7550

## Contact information

- **Practice address:** 156 CLINTON ST, WATERTOWN, NY 13601-3602
- **Practice address phone:** (315) 782-7550
- **Mailing address:** 156 CLINTON ST, WATERTOWN, NY 13601-3602
- **Mailing address phone:** (315) 782-7550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 210993 | NY | Yes |

## Other

- **Enumeration date:** 03/14/2007
- **Last updated:** 08/22/2020

## 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 |