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General NPI Number Information
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NPI Number | 1902902901
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Entity Type | Organization
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Legal Business Name | PRIME CARE PHYSICIANS, P.L.L.C.
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 03/28/2012
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Provider Practice Location Address
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Address Line | 26 NORTH FRONT STREET
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City | NEW PALTZ
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State | NY
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Zip | 12561
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Country | US
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Telephone | 845-255-7900
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Fax | 845-255-7901
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Provider Business Mailing Address
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Address Line | 26 NORTH FRONT STREET
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City | NEW PALTZ
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State | NY
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Zip | 12561
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Country | US
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Telephone | 845-255-7900
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Fax | 845-255-7901
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Authorized Official
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Title or Position | DIRECTOR OF ADMINISTRATION
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Name | MR. MICHAEL WHALEN
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Credential |
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Telephone | 518-435-2704
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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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