Provider Demographics
NPI:1790888915
Name:PRIMARY CARE PHYSICIANS GROUP, LLC
Entity Type:Organization
Organization Name:PRIMARY CARE PHYSICIANS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:RUBINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-736-4430
Mailing Address - Street 1:101 OLD SHORT HILLS RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1000
Mailing Address - Country:US
Mailing Address - Phone:973-736-4430
Mailing Address - Fax:973-736-3733
Practice Address - Street 1:101 OLD SHORT HILLS RD
Practice Address - Street 2:SUITE 211
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1000
Practice Address - Country:US
Practice Address - Phone:973-736-4430
Practice Address - Fax:973-736-3733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty