Provider Demographics
NPI:1033718762
Name:WHITE PLAINS PRIMARY CARE
Entity Type:Organization
Organization Name:WHITE PLAINS PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:KNOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-417-6424
Mailing Address - Street 1:50 POST OFFICE RD STE 304
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3704
Mailing Address - Country:US
Mailing Address - Phone:240-349-2448
Mailing Address - Fax:240-349-2243
Practice Address - Street 1:50 POST OFFICE RD STE 304
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3704
Practice Address - Country:US
Practice Address - Phone:240-349-2448
Practice Address - Fax:240-349-2243
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHITE PLAINS PRIMARY CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty