Provider Demographics
NPI:1811219645
Name:ORANGE PRIMARY MEDICAL CARE, PLLC
Entity Type:Organization
Organization Name:ORANGE PRIMARY MEDICAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHOBHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATHANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-643-2309
Mailing Address - Street 1:5159 ROUTE 9W
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1452
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5159 ROUTE 9W
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1452
Practice Address - Country:US
Practice Address - Phone:914-643-2309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-21
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234544207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty