Organization
PRIME CARE PHYSICIANS, PLLC
Active
Other names
Northeast Advanced Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J. WHALEN MBA (DIRECTOR OF ADMINISTRATION)
(518) 435-2704
Entity
Organization
Contact information
Practice address
279 TROY RD, ROUTE 4, RENSSELAER, NY 12144-9499
(518) 880-6300
Mailing address
4 ATRIUM DR, SUITE 100, ALBANY, NY 12205-1441
(518) 435-2740
(518) 649-4025
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02616571
—
NY
05
—
1011152
—
VT
Enumeration date
07/17/2012
Last updated
07/17/2012
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