Provider Demographics
NPI:1508280777
Name:DEFINITE PRIMARY CARE, LLC
Entity Type:Organization
Organization Name:DEFINITE PRIMARY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CORINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMIGHELSCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-680-1676
Mailing Address - Street 1:1767 MORRIS AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-3532
Mailing Address - Country:US
Mailing Address - Phone:732-680-1676
Mailing Address - Fax:
Practice Address - Street 1:1767 MORRIS AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-3532
Practice Address - Country:US
Practice Address - Phone:732-680-1676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-09
Last Update Date:2014-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty