| Primary Health Of Northern New York, Pllc | |
|
156 Clinton St Watertown NY 13601-3602 | |
| (315) 782-7550 | |
| Not Available |
| Full Name | Primary Health Of Northern New York, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 156 Clinton St, Watertown, New York |
| Authorized Official Name and Position | Elizabeth A Thurheimer (OWNER AND ORIGINAL MEMBER) |
| Authorized Official Contact | 3157827550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Health Of Northern New York, Pllc 156 Clinton St Watertown NY 13601-3602 Ph: (315) 782-7550 | Primary Health Of Northern New York, Pllc 156 Clinton St Watertown NY 13601-3602 Ph: (315) 782-7550 |
| NPI Number | 1932232378 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932232378 | NPI | - | NPPES |
| 01862091 | Medicaid | NY | |
| P00082023 | Other | NY | PALMETTO RR MEDICARE |
| 711552 | Other | NY | MVP PROVIDER ID |
| DB0031 | Other | NY | GRP # PALMETTO RR MCR |
| 142658XX | Other | NY | PREFERRED CARE |
| 5996936 | Other | NY | GHI PROVIDER ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 210993 (New York) | Primary |
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