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General NPI Number Information
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NPI Number | 1881007516
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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 | 06/10/2014
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 5 COLD HILL RD S STE 6
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City | MENDHAM
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State | NJ
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Zip | 07945-3207
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Country | US
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Telephone | 973-543-1996
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Fax | 973-543-5775
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Provider Business Mailing Address
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Address Line | 402 LIPPINCOTT DR
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City | MARLTON
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State | NJ
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Zip | 08053-4112
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Country | US
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Telephone | 856-782-3300
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Fax | 856-504-8029
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Authorized Official
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Title or Position | CEO
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Name | 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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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