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General NPI Number Information
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NPI Number | 1235195462
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE HEALTH PARTNERS
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 140 MAIN ST
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City | HOOSICK FALLS
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State | NY
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Zip | 12090-2012
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Country | US
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Telephone | 518-686-4337
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Fax | 518-686-4073
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Provider Business Mailing Address
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Address Line | 600 BLAIR PARK RD SUITE 190
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City | WILLISTON
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State | VT
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Zip | 05495-7586
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Country | US
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Telephone | 802-860-1145
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Fax | 802-872-0282
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Authorized Official
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Title or Position | COO
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Name | ROBERT E BYCER
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Credential |
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Telephone | 802-860-1145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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