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NPI Code Detail

MEDICARE: PRIME CARE MEDICAL ASSOCIATES

MEDICARE: PRIME CARE MEDICAL ASSOCIATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1447252291
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIME CARE MEDICAL ASSOCIATES
Provider Business Mailing Address
First Line : 16-18 RIDGE RD
Second Line :
City : NORTH ARLINGTON
State : NJ
Zip : 07031-6314
Country : US
Telephone Number : 201-997-1010
Fax Number : 201-997-7436
Provider Business Practice Location Address
First Line : 16-18 RIDGE RD
Second Line :
City : NORTH ARLINGTON
State : NJ
Zip : 07031-6314
Country : US
Telephone Number : 201-997-1010
Fax Number : 201-997-7436
Authorized Official
Title or Position : PRESIDENT
Name : ERIC M JACKSON
Credential : M.D.
Telephone Number : 201-997-1010
Provider Enumeration Date : 08/11/2005
Last Update Date : 08/22/2020

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Directions to “PRIME CARE MEDICAL ASSOCIATES ” Practice Location

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