Organization
PRIME CARE PHYSICIANS, P.L.L.C.
Active
Other names
MidValley Cardiology
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL WHALEN (DIRECTOR OF ADMINISTRATION)
(518) 435-2704
Entity
Organization
Contact information
Practice address
111 MARYS AVE, SUITE 3, KINGSTON, NY 12401-5852
(845) 339-3663
(845) 339-3629
Mailing address
4 ATRIUM DR, SUITE 100, ALBANY, NY 12205-1441
(518) 435-2704
(518) 458-2610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
54964
NY
207RC0000X
Cardiovascular Disease Physician
Primary
54964
NY
207RC0001X
Clinical Cardiac Electrophysiology Physician
54964
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
54964
NY
207UN0901X
Nuclear Cardiology Physician
54964
NY
2083P0901X
Public Health & General Preventive Medicine Physician
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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