MEDICARE: AAA PRIMARY MEDICAL CARE, PC

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
1	261Q00000X	Clinic/Center	165660	NY

General Provider Information

NPI Number	:	1518123405
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AAA PRIMARY MEDICAL CARE, PC

Provider Business Mailing Address
First Line	:	1387 CASTLE HILL AVE
Second Line	:	UNIT 6
City	:	BRONX
State	:	NY
Zip	:	10462-4833
Country	:	US
Telephone Number	:	718-931-4200
Fax Number	:	718-931-8869

Provider Business Practice Location Address
First Line	:	1387 CASTLE HILL AVE
Second Line	:	UNIT 6
City	:	BRONX
State	:	NY
Zip	:	10462-4833
Country	:	US
Telephone Number	:	718-931-4200
Fax Number	:	718-931-8869

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STUART LARRY SAFTCHICK
Credential	:	MD
Telephone Number	:	718-931-4200

Provider Enumeration Date	:	07/31/2008
Last Update Date	:	06/08/2009

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