Provider Demographics
NPI:1518123405
Name:AAA PRIMARY MEDICAL CARE, PC
Entity Type:Organization
Organization Name:AAA PRIMARY MEDICAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:SAFTCHICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-931-4200
Mailing Address - Street 1:1387 CASTLE HILL AVE
Mailing Address - Street 2:UNIT 6
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4833
Mailing Address - Country:US
Mailing Address - Phone:718-931-4200
Mailing Address - Fax:718-931-8869
Practice Address - Street 1:1387 CASTLE HILL AVE
Practice Address - Street 2:UNIT 6
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-4833
Practice Address - Country:US
Practice Address - Phone:718-931-4200
Practice Address - Fax:718-931-8869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165660261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE49287Medicare UPIN