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General NPI Number Information
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NPI Number | 1144130022
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Entity Type | Organization
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Legal Business Name | PRIMECARE FAMILY MEDICINE
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Dates
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Enumeration Date | 09/11/2026
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Last Update Date | 09/11/2026
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Provider Practice Location Address
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Address Line | 57 NORTH ST STE 422423
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City | DANBURY
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State | CT
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Zip | 06810-5660
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Country | US
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Telephone | 203-746-2436
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Fax | 203-746-3205
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Provider Business Mailing Address
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Address Line | 57 NORTH ST STE 422423
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City | DANBURY
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State | CT
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Zip | 06810-5660
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | SAMENTHA GILLES
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Credential | NP
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Telephone | 203-343-8077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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