Provider Demographics
NPI:1497970826
Name:PRIMARY CARE ASSOCIATES,PC
Entity Type:Organization
Organization Name:PRIMARY CARE ASSOCIATES,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:RALABATE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-378-3696
Mailing Address - Street 1:2890 MAIN ST
Mailing Address - Street 2:STE 2A
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-4980
Mailing Address - Country:US
Mailing Address - Phone:203-378-3696
Mailing Address - Fax:203-383-7222
Practice Address - Street 1:2890 MAIN ST
Practice Address - Street 2:STE 2A
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-4980
Practice Address - Country:US
Practice Address - Phone:203-378-3696
Practice Address - Fax:203-383-7222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT024731207R00000X, 208000000X
CT001515363L00000X
CT002345363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP30839Medicare UPIN
CTB83270Medicare UPIN
CTP41666Medicare UPIN