Organization
PORT CITY EMERGENCY PHYSICIANS LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE WHITMAN DO (MANAGING PARTNER)
(337) 609-1221
Entity
Organization
Contact information
Practice address
3045 EAST AVE, CENTRAL SQUARE, NY 13036-9502
(866) 916-5259
(231) 922-4030
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03520683
—
NY
01
—
DO1413
RR MCR
NY
01
—
J100000030
MEDICARE PIN
NY
Enumeration date
08/29/2012
Last updated
01/05/2023
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