Provider Demographics
NPI:1902862113
Name:PRIMARY CARE HEALTH PARTNERS
Entity Type:Organization
Organization Name:PRIMARY CARE HEALTH PARTNERS
Other - Org Name:PLATTSBURGH PRIMARY CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:BYCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-860-1145
Mailing Address - Street 1:600 BLAIR PARK RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-7586
Mailing Address - Country:US
Mailing Address - Phone:802-860-1145
Mailing Address - Fax:802-872-0282
Practice Address - Street 1:159 MARGARET ST
Practice Address - Street 2:SUITE 103
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1874
Practice Address - Country:US
Practice Address - Phone:518-562-0151
Practice Address - Fax:518-562-2718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty