Provider Demographics
NPI:1225282841
Name:PRIMARY CARE PARTNERS, PC
Entity Type:Organization
Organization Name:PRIMARY CARE PARTNERS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-709-3508
Mailing Address - Street 1:166 WATERBURY RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PROSPECT
Mailing Address - State:CT
Mailing Address - Zip Code:06712-1200
Mailing Address - Country:US
Mailing Address - Phone:203-758-0878
Mailing Address - Fax:203-758-0877
Practice Address - Street 1:166 WATERBURY RD
Practice Address - Street 2:SUITE 300
Practice Address - City:PROSPECT
Practice Address - State:CT
Practice Address - Zip Code:06712-1200
Practice Address - Country:US
Practice Address - Phone:203-758-0878
Practice Address - Fax:203-758-0877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty