Provider Demographics
NPI:1972278745
Name:NEWBURGH PRIMARY CARE PC
Entity Type:Organization
Organization Name:NEWBURGH PRIMARY CARE PC
Other - Org Name:ELITE ORTHOPEDIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:YELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUBINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-307-1350
Mailing Address - Street 1:244 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-5414
Mailing Address - Country:US
Mailing Address - Phone:516-307-1350
Mailing Address - Fax:
Practice Address - Street 1:244 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5414
Practice Address - Country:US
Practice Address - Phone:516-307-1350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty