Patricia P Primomo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

058619 Issued in NY

Practice address

2310 Nott Street East
Niskayuna, NY 12309

Phone

(518) 374-3060

Fax

(518) 374-5278

NPI assigned

Jun 4, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1932589983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 NOTT STREET EAST",
            "city": "NISKAYUNA",
            "state": "NY",
            "postal_code": "12309",
            "telephone_number": "518-374-3060",
            "fax_number": "518-374-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 NOTT STREET EAST",
            "city": "NISKAYUNA",
            "state": "NY",
            "postal_code": "12309",
            "telephone_number": "518-374-3060",
            "fax_number": "518-374-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIMOMO",
        "first_name": "PATRICIA",
        "middle_name": "P",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-04",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "058619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nickisha Pooran, RDN
• Carol C. Possin, PHD
• Susanne Marie Poulette, M.S. IN ED.
• Carole A Praga, LMHC
• John Pramenko, MD
• Priority Pharmaceutical Service LLC
• Joan Carpenter Pritchard I, MA-CCC-SLP
• Melissa A Raduazzo, FNP
• Robin L. Rappazzo, RD
• Janice Marie Rattner, RN

• General Practice Dentistry in Niskayuna, NY
• Providers in Niskayuna, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.