Provider Demographics
NPI:1245634211
Name:PRIMARY CARE MEDICINE AND PEDIATRICS LLC
Entity type:Organization
Organization Name:PRIMARY CARE MEDICINE AND PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:TROLIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-525-1611
Mailing Address - Street 1:94 N ELM ST
Mailing Address - Street 2:UNIT 206
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-1647
Mailing Address - Country:US
Mailing Address - Phone:413-562-1650
Mailing Address - Fax:413-562-1603
Practice Address - Street 1:94 N ELM ST
Practice Address - Street 2:UNIT 206
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-1647
Practice Address - Country:US
Practice Address - Phone:413-562-1650
Practice Address - Fax:413-562-1603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty