Healthcare Provider Details

I. General information

NPI: 1376558759
Provider Name (Legal Business Name): PRIME MEDICAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 BRIDGE ST
METUCHEN NJ
08840-2254
US

IV. Provider business mailing address

212 BRIDGE ST
METUCHEN NJ
08840-2254
US

V. Phone/Fax

Practice location:
  • Phone: 732-632-1700
  • Fax: 732-632-1704
Mailing address:
  • Phone: 732-632-1700
  • Fax: 732-632-1704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KAVITHA THUKKARAM
Title or Position: OWNER/ PHYSICIAN
Credential: MD
Phone: 732-632-1700