Organization
PRIME CARE PHYSICIANS, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL WHALEN (DIRECTOR OF ADMINISTRATION)
(518) 435-2704
Entity
Organization
Contact information
Practice address
400 PATROON CREEK BLVD, SUITE 100, ALBANY, NY 12206-5004
(518) 618-1662
(518) 618-1664
Mailing address
4 ATRIUM DR, SUITE 100, ALBANY, NY 12205-1441
(518) 435-2704
(518) 458-2610
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
2085N0700X
Neuroradiology Physician
54964
NY
2085N0904X
Nuclear Radiology Physician
54964
NY
2085R0202X
Diagnostic Radiology Physician
54964
NY
2085R0204X
Vascular & Interventional Radiology Physician
54964
NY
363AM0700X
Medical Physician Assistant
54964
NY
363L00000X
Nurse Practitioner
54964
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02616571
—
NY
Enumeration date
05/01/2007
Last updated
03/28/2012
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