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General NPI Number Information
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NPI Number | 1235569708
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE PARTNERS, LLC
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Dates
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Enumeration Date | 11/20/2013
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Last Update Date | 11/20/2013
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Provider Practice Location Address
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Address Line | 925 US HIGHWAY 202 STE 202
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City | NESHANIC STATION
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State | NJ
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Zip | 08853-3503
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Country | US
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Telephone | 908-788-9468
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Fax | 908-788-5720
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Provider Business Mailing Address
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Address Line | PO BOX 2403
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City | VOORHEES
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State | NJ
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Zip | 08043-6403
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Country | US
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Telephone | 856-782-3300
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Fax | 856-504-8206
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Authorized Official
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Title or Position | CEO
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Name | DR. DAVID SHULKIN
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Credential | MD
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Telephone | 856-782-3300
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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 | 25MA04549000
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License Number State | NJ
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