Healthcare Provider Details

I. General information

NPI: 1174954283
Provider Name (Legal Business Name): PRIMARY CARE PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2013
Last Update Date: 11/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 S JEFFERSON RD STE 200
WHIPPANY NJ
07981-1037
US

IV. Provider business mailing address

PO BOX 2403
VOORHEES NJ
08043-6403
US

V. Phone/Fax

Practice location:
  • Phone: 973-538-6116
  • Fax: 973-538-3712
Mailing address:
  • Phone: 856-782-3300
  • Fax: 856-504-8029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID SHULKIN
Title or Position: CEO
Credential: MD
Phone: 856-782-3300