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NPI Code Detail

MEDICARE: PRIMARY PARTNERCARE PHYSICIANS PLLC

MEDICARE: PRIMARY PARTNERCARE PHYSICIANS PLLC
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 : 1891318168
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIMARY PARTNERCARE PHYSICIANS PLLC
Provider Business Mailing Address
First Line : 1010 NORTHERN BLVD STE 328
Second Line :
City : GREAT NECK
State : NY
Zip : 11021-5329
Country : US
Telephone Number : 516-354-7900
Fax Number :
Provider Business Practice Location Address
First Line : 2800 MARCUS AVE STE 203B
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11042-1008
Country : US
Telephone Number : 516-354-7900
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. HARRY JACOB
Credential : MD
Telephone Number : 516-354-7900
Provider Enumeration Date : 05/21/2020
Last Update Date : 01/30/2026

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