Provider Demographics
NPI:1144300070
Name:PRIMARY CARE HEALTH SERVICE
Entity type:Organization
Organization Name:PRIMARY CARE HEALTH SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:SEIDENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-854-2019
Mailing Address - Street 1:3009 BROADWAY
Mailing Address - Street 2:PRIMARY CARE HEALTH SERVICE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-6598
Mailing Address - Country:US
Mailing Address - Phone:212-854-2019
Mailing Address - Fax:212-854-2702
Practice Address - Street 1:3009 BROADWAY
Practice Address - Street 2:PRIMARY CARE HEALTH SERVICE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-6598
Practice Address - Country:US
Practice Address - Phone:212-854-2019
Practice Address - Fax:212-854-2702
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BARNARD COLLEGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-16
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health