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General NPI Number Information
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NPI Number | 1649369067
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Entity Type | Organization
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Legal Business Name | SETAUKET PRIMARY MEDICAL CARE PC
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 12 BREWSTER LN
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City | EAST SETAUKET
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State | NY
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Zip | 11733-2922
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Country | US
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Telephone | 631-941-4480
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Fax | 631-941-4054
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Provider Business Mailing Address
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Address Line | 12 BREWSTER LN
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City | EAST SETAUKET
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State | NY
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Zip | 11733-2922
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Country | US
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Telephone | 631-941-4480
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Fax | 631-941-4054
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Authorized Official
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Title or Position | OWNER
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Name | DR. TANYA ADAMS
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Credential | D.O.
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Telephone | 631-941-4480
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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 | 2278671
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4893961
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F334091
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F3040001
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License Number State | NY
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