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PRIME HEALTHCARE PC NPI 1184819302


NPI Information

NPI: 1184819302
Provider Name: PRIME HEALTHCARE, PC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 07D1074388

Address:
30 JORDAN LN
WETHERSFIELD, CT
ZIP 06109
Phone: (860) 263-0253
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PRIME HEALTHCARE, PC is an internal medicine in Wethersfield, CT. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PRIME HEALTHCARE, PC NPI is 1184819302. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

30 JORDAN LN
WETHERSFIELD, CT
ZIP 06109-278
Phone: (860) 263-0253
Fax: (860) 263-0262

The provider's authorized official is Susan Albano .
The authorized official title is Ceo and has the following contact phone number (860) 263-0253.

The CLIA number assigned to this NPI record is 07D1074388 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/11/2007 and was last updated on 8/3/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RC0200XInternal MedicineCritical Care MedicineNo
2207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismNo
3207RG0100XInternal MedicineGastroenterologyNo
4207RG0300XInternal MedicineGeriatric MedicineNo
5207RP1001XInternal MedicinePulmonary DiseaseNo
6208M00000XHospitalistNo
7363A00000XPhysician AssistantNo
8363L00000XNurse PractitionerNo
9363LA2200XNurse PractitionerAdult HealthNo
10363LF0000XNurse PractitionerFamilyNo
11208000000XPediatrics54316CONNECTICUTNo
12207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1008058707MEDICAIDCONNECTICUT
2004185147MEDICAIDCONNECTICUT
3004201480MEDICAIDCONNECTICUT
4C02239MEDICARE PINCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.