Healthcare Provider Details
I. General information
NPI: 1851670814
Provider Name (Legal Business Name): PRIMARY CARE PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/09/2011
Last Update Date: 08/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
665 MARTINSVILLE RD SUITE 218
BASKING RIDGE NJ
07920-4700
US
IV. Provider business mailing address
PO BOX 2403
VOORHEES NJ
08043-6403
US
V. Phone/Fax
- Phone: 908-607-1877
- Fax: 908-607-1866
- Phone: 856-782-3300
- Fax: 856-504-8029
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DAVID
J.
SHULKIN
Title or Position: CEO
Credential: MD
Phone: 973-971-5450