Provider Demographics
NPI:1851890289
Name:NY PRIMARY CARE PRACTICE, PC
Entity Type:Organization
Organization Name:NY PRIMARY CARE PRACTICE, PC
Other - Org Name:FIVE STAR URGENT CARE HUDSON
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARDINALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-699-9032
Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:
Mailing Address - City:ELLICOTTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14731-0500
Mailing Address - Country:US
Mailing Address - Phone:716-699-9032
Mailing Address - Fax:716-699-9035
Practice Address - Street 1:446 FAIRVIEW AVE STE 200
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-1048
Practice Address - Country:US
Practice Address - Phone:518-267-3496
Practice Address - Fax:518-237-3497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care