Provider Demographics
NPI: | 1770694374 |
---|---|
Name: | SENIOR HEALTH CARE ASSOCIATES, PC |
Entity type: | Organization |
Organization Name: | SENIOR HEALTH CARE ASSOCIATES, PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ERIC |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BARON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 248-559-3400 |
Mailing Address - Street 1: | 24100 SOUTHFIELD RD |
Mailing Address - Street 2: | SUITE 200 |
Mailing Address - City: | SOUTHFIELD |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48075-2819 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 248-559-3400 |
Mailing Address - Fax: | 248-557-5580 |
Practice Address - Street 1: | 24100 SOUTHFIELD RD |
Practice Address - Street 2: | SUITE 200 |
Practice Address - City: | SOUTHFIELD |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48075-2819 |
Practice Address - Country: | US |
Practice Address - Phone: | 248-559-3400 |
Practice Address - Fax: | 248-557-5580 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-08-31 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RG0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | Group - Multi-Specialty |