Provider Demographics
NPI:1447000658
Name:PRIMARY CARE MEDICAL PLLC
Entity type:Organization
Organization Name:PRIMARY CARE MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAHIDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOWDUARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-212-0000
Mailing Address - Street 1:1 FULTON AVE STE 12A
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-3648
Mailing Address - Country:US
Mailing Address - Phone:718-212-0000
Mailing Address - Fax:929-822-7518
Practice Address - Street 1:1 FULTON AVE STE 12A
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3648
Practice Address - Country:US
Practice Address - Phone:718-212-0000
Practice Address - Fax:929-822-7518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty