Provider Demographics
NPI:1952689879
Name:PRIMARY CARE PARTNERS, LLC
Entity Type:Organization
Organization Name:PRIMARY CARE PARTNERS, LLC
Other - Org Name:EASTERN VASCULAR ASSOCIATES- A DIVISION OF PRIMARY CARE PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHULKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-971-5450
Mailing Address - Street 1:475 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6459
Mailing Address - Country:US
Mailing Address - Phone:973-971-5000
Mailing Address - Fax:
Practice Address - Street 1:16 POCONO RD
Practice Address - Street 2:SUITE 313
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2901
Practice Address - Country:US
Practice Address - Phone:973-625-0112
Practice Address - Fax:973-625-0721
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIMARY CARE PARTNERS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty