Provider Demographics
NPI:1740682871
Name:WESTCHESTER PRIMARY MEDICAL PRACTICE,P.C.
Entity type:Organization
Organization Name:WESTCHESTER PRIMARY MEDICAL PRACTICE,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SILVY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MATHEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-980-1678
Mailing Address - Street 1:PO BOX 115
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-0115
Mailing Address - Country:US
Mailing Address - Phone:914-980-1678
Mailing Address - Fax:914-762-1166
Practice Address - Street 1:100 S HIGHLAND AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-5634
Practice Address - Country:US
Practice Address - Phone:914-762-1486
Practice Address - Fax:914-762-1166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198743207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01733715Medicaid
NY01733715Medicaid