Provider Demographics
NPI:1639367816
Name:ROCK CREEK FAMILY MEDICINE, LLP
Entity Type:Organization
Organization Name:ROCK CREEK FAMILY MEDICINE, LLP
Other - Org Name:ROCK CREEK GERIATRIC MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:TOMSKO
Authorized Official - Last Name:NAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-294-1864
Mailing Address - Street 1:11140 ROCKVILLE PIKE
Mailing Address - Street 2:#348
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3106
Mailing Address - Country:US
Mailing Address - Phone:301-294-1864
Mailing Address - Fax:301-349-5177
Practice Address - Street 1:11140 ROCKVILLE PIKE
Practice Address - Street 2:#348
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3106
Practice Address - Country:US
Practice Address - Phone:301-294-1864
Practice Address - Fax:301-349-5177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G00023OtherMEDICARE GROUP NUMBER
MD000A93R23Medicare PIN
G65669Medicare UPIN