Individual
DR. LARA KRISTINA PRIMAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11050 MT. BELVEDERE BLVD., USA MEDDAC/CREDENTIALS, FORT DRUM, NY 13602-5004
(315) 772-4025
(315) 772-9498
Mailing address
11050 MT. BELVEDERE BLVD., USA MEDDAC ATTN: CREDENTIALS, FORT DRUM, NY 13602-5004
(315) 772-4025
(315) 772-9498
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD063446L
PA
Other
Enumeration date
09/07/2006
Last updated
07/08/2007
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