| Setauket Primary Medical Care Pc | |
|
12 Brewster Ln East Setauket NY 11733-2922 | |
| (631) 941-4480 | |
| (631) 941-4054 |
| Full Name | Setauket Primary Medical Care Pc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 12 Brewster Ln, East Setauket, New York |
| Authorized Official Name and Position | Tanya Adams (OWNER) |
| Authorized Official Contact | 6319414480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Setauket Primary Medical Care Pc 12 Brewster Ln East Setauket NY 11733-2922 Ph: (631) 941-4480 | Setauket Primary Medical Care Pc 12 Brewster Ln East Setauket NY 11733-2922 Ph: (631) 941-4480 |
| NPI Number | 1649369067 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2062487150 |
|---|---|
| Medicare Enrollment ID | O20040901000340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649369067 | NPI | - | NPPES |
| DC2402 | Other | NY | MEDICARE RAIL ROAD |
| Provider Name | Tanya Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700879707 PECOS PAC ID: 7315931839 Enrollment ID: I20040408001055 |
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