Provider Demographics
NPI:1033550496
Name:ACCESS PRIMARY CARE LLC
Entity Type:Organization
Organization Name:ACCESS PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CRISANTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-213-0119
Mailing Address - Street 1:12308 OCEAN GTWY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:OCEAN CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21842-9341
Mailing Address - Country:US
Mailing Address - Phone:410-213-0119
Mailing Address - Fax:410-213-2875
Practice Address - Street 1:12308 OCEAN GTWY
Practice Address - Street 2:SUITE 3
Practice Address - City:OCEAN CITY
Practice Address - State:MD
Practice Address - Zip Code:21842-9341
Practice Address - Country:US
Practice Address - Phone:410-213-0119
Practice Address - Fax:410-213-2875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD612301500Medicaid
MDM41833OtherCDS
MDD0050255OtherMEDICAL LICENSE
MDD0050255OtherMEDICAL LICENSE
MD486PMedicare PIN
MDD0050255OtherMEDICAL LICENSE