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Organization

PRIME CARE PHYSICIANS, P.L.L.C.

Active
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Organization

PRIME CARE PHYSICIANS, P.L.L.C.

Active
Other names
Prime Care Physicians, P.L.L.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
4 NORMANSKILL BLVD, DELMAR, NY 12054-1335
(518) 435-2740
(518) 458-2610
Mailing address
4 ATRIUM DR, SUITE 100, ALBANY, NY 12205-1441
(518) 435-2704
(518) 458-2610

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
54964
NY
363LP0200X
Pediatric Nurse Practitioner
54964
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02616571
NY
Enumeration date
04/26/2007
Last updated
03/28/2012
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