Healthcare Provider Details

I. General information

NPI: 1659180800
Provider Name (Legal Business Name): S&S PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11294 MONTGOMERY RD
CINCINNATI OH
45249-2319
US

IV. Provider business mailing address

PO BOX 10417
HOLYOKE MA
01041-2017
US

V. Phone/Fax

Practice location:
  • Phone: 513-815-7000
  • Fax: 513-223-3645
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAUSHIK SARKAR
Title or Position: OWNER
Credential:
Phone: 513-815-7000