Provider Demographics
NPI:1285189027
Name:PRIORITY PRIVATE MEDICAL CARE, PC
Entity Type:Organization
Organization Name:PRIORITY PRIVATE MEDICAL CARE, PC
Other - Org Name:PRIORITY PRIVATE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-535-8939
Mailing Address - Street 1:170 E 77TH ST LOWR LEVEL
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1912
Mailing Address - Country:US
Mailing Address - Phone:646-535-8939
Mailing Address - Fax:
Practice Address - Street 1:170 E 77TH ST LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1912
Practice Address - Country:US
Practice Address - Phone:646-535-8939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service