| Eden Primary Care | |
|
8274 N Main St Eden NY 14057-1104 | |
| (716) 725-8114 | |
| Not Available |
| Full Name | Eden Primary Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 8274 N Main St, Eden, New York |
| Authorized Official Name and Position | Brigid O'gorman (OWNER) |
| Authorized Official Contact | 7165757282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eden Primary Care 8274 N Main St Eden NY 14057-1104 Ph: (716) 575-7282 | Eden Primary Care 8274 N Main St Eden NY 14057-1104 Ph: (716) 725-8114 |
| NPI Number | 1154071934 |
|---|---|
| Provider Enumeration Date | 03/25/2022 |
| Last Update Date | 04/01/2026 |
| Certification Date | 04/01/2026 |
| Medicare PECOS PAC ID | 2860870318 |
|---|---|
| Medicare Enrollment ID | O20220613000571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154071934 | NPI | - | NPPES |
| 301295 | Other | NY | NYS MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207QG0300X | Family Medicine - Geriatric Medicine | () | Secondary |
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Deborah a Dibble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952384067 PECOS PAC ID: 5597661330 Enrollment ID: I20031211000305 |
| Provider Name | Brigid D O'gorman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851889992 PECOS PAC ID: 0042564288 Enrollment ID: I20220613000624 |
| Provider Name | Leigh-anne B Diorio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326715228 PECOS PAC ID: 5799154134 Enrollment ID: I20221207001974 |
Suresh D Ghate P.C. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8504 N Main St, Eden, NY 14057 Phone: 716-992-3230 Fax: 716-992-3464 |