Healthcare Provider Details

I. General information

NPI: 1316274061
Provider Name (Legal Business Name): PRIMECARE MEDICAL SERVICE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2009
Last Update Date: 11/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3371 RICHIMOD AVENUE
STATEN ISLAND NY
10312-2025
US

IV. Provider business mailing address

3371 RICHMOND AVE
STATEN ISLAND NY
10312-2025
US

V. Phone/Fax

Practice location:
  • Phone: 718-966-5466
  • Fax: 718-966-2256
Mailing address:
  • Phone: 718-966-5466
  • Fax: 718-966-2256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: FRANK J ARBUCCI
Title or Position: PRESIDENT
Credential: MD
Phone: 718-966-5466