Healthcare Provider Details

I. General information

NPI: 1568377943
Provider Name (Legal Business Name): MEDCARE PRIMARY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 WHITE STREET STE 6
DANBURY CT
06810
US

IV. Provider business mailing address

35 WHITE STREET STE 6
DANBURY CT
06810
US

V. Phone/Fax

Practice location:
  • Phone: 203-816-2255
  • Fax: 203-816-2250
Mailing address:
  • Phone: 203-816-2255
  • Fax: 203-816-2250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TAMANTHA WHITE
Title or Position: NURE PRACTITIONER
Credential: APRN
Phone: 917-951-5597