Primerose Medical P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

254613 Issued in NY

Legal business name

PRIMEROSE MEDICAL P.C.

Practice address

11 Bench LN
Levittown, NY 11756-1802

Phone

(718) 795-8272

NPI assigned

Oct 29, 2013

Last updated

Oct 29, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Olubunmi Abiye Bolaji, M.D.NPI 1619100633

Title

Owner

Phone

(718) 795-8272

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Olubunmi Abiye Bolaji, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Commack, NY
  • NPI 1619100633
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1699103721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BENCH LN",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117561802",
            "telephone_number": "718-795-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BENCH LN",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117561802",
            "telephone_number": "718-795-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMEROSE MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "BOLAJI",
        "authorized_official_first_name": "OLUBUNMI",
        "authorized_official_middle_name": "ABIYE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-795-8272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "254613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne Marie Pisciotta, AU.D., CCC-A
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• Lubna Qazi

• Primary Care Clinic/Center in Levittown, NY
• Providers in Levittown, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.