| Prime Medical Care Llc | |
|
205 Bridge St Metuchen NJ 08840-2290 | |
| (732) 632-1700 | |
| (732) 632-1704 |
| Full Name | Prime Medical Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 205 Bridge St, Metuchen, New Jersey |
| Authorized Official Name and Position | Kavitha Thukkaram (MD) |
| Authorized Official Contact | 7326321700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Medical Care Llc 205 Bridge St Metuchen NJ 08840-2290 Ph: (732) 632-1700 | Prime Medical Care Llc 205 Bridge St Metuchen NJ 08840-2290 Ph: (732) 632-1700 |
| NPI Number | 1376558759 |
|---|---|
| Provider Enumeration Date | 07/31/2006 |
| Last Update Date | 12/07/2007 |
| Medicare PECOS PAC ID | 0446430326 |
|---|---|
| Medicare Enrollment ID | O20110209000922 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376558759 | NPI | - | NPPES |
| 0005681 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MA72859 (New Jersey) | Primary |
| Provider Name | Kavitha Thukkaram |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003854282 PECOS PAC ID: 1355521238 Enrollment ID: I20110209000951 |
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