Provider Demographics
NPI:1285989046
Name:PRIMARY CARE ASSOCIATES OF ROCKLAND PC
Entity type:Organization
Organization Name:PRIMARY CARE ASSOCIATES OF ROCKLAND PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:P
Authorized Official - Last Name:CRICCHIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-362-1998
Mailing Address - Street 1:971 ROUTE 45
Mailing Address - Street 2:SUITE 204
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3500
Mailing Address - Country:US
Mailing Address - Phone:845-362-1998
Mailing Address - Fax:845-362-3656
Practice Address - Street 1:971 ROUTE 45
Practice Address - Street 2:SUITE 204
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3500
Practice Address - Country:US
Practice Address - Phone:845-362-1998
Practice Address - Fax:845-362-3656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY188670207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty