Provider Demographics
NPI:1821277427
Name:ASSOCIATES IN PRIMARY CARE MEDICINE, INC.
Entity Type:Organization
Organization Name:ASSOCIATES IN PRIMARY CARE MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KERZER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:401-467-3115
Mailing Address - Street 1:857 POST RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-3360
Mailing Address - Country:US
Mailing Address - Phone:401-467-3115
Mailing Address - Fax:401-467-9120
Practice Address - Street 1:857 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-3360
Practice Address - Country:US
Practice Address - Phone:401-467-3115
Practice Address - Fax:401-467-9120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDO00303207Q00000X
RIMD11053207Q00000X
RINPP37217363L00000X
RINPP37523363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9003198Medicaid
RI119094449Medicare PIN