Organization
PRIME CARE PHYSICIANS, P.L.L.C.
Active
Organization
PRIME CARE PHYSICIANS, P.L.L.C.
Active
Other names
Northeast Advance Imaging, P.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
315 S MANNING BLVD, MEDICAL IMAGING DEPARTMENT, ALBANY, NY 12208-1707
(518) 525-1852
(518) 525-5187
Mailing address
4 ATRIUM DR, SUITE 100, ALBANY, NY 12205-1441
(518) 435-2704
(518) 458-2610
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
54964
NY
2085N0904X
Nuclear Radiology Physician
54964
NY
2085R0202X
Diagnostic Radiology Physician
Primary
54964
NY
2085R0204X
Vascular & Interventional Radiology Physician
54964
NY
363AM0700X
Medical Physician Assistant
54964
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02616571
—
NY
Enumeration date
04/25/2007
Last updated
03/28/2012
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