Provider Demographics
NPI:1821859208
Name:ALBIN PRIMARY CARE LLC
Entity Type:Organization
Organization Name:ALBIN PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DMITRY
Authorized Official - Middle Name:ANATOLYEVICH
Authorized Official - Last Name:ALBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-552-7499
Mailing Address - Street 1:PO BOX 89
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-0089
Mailing Address - Country:US
Mailing Address - Phone:352-460-8811
Mailing Address - Fax:
Practice Address - Street 1:31 OLD ROUTE 7
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-1711
Practice Address - Country:US
Practice Address - Phone:203-740-4455
Practice Address - Fax:203-740-4477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty