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NPI Code Detail

MEDICARE: CITY MEDICAL OF NEW JERSEY, PC

MEDICARE: CITY MEDICAL OF NEW JERSEY, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1417325986
Entity Type Code : Organization
Provider Name (Legal Business Name) : CITY MEDICAL OF NEW JERSEY, PC
Provider Business Mailing Address
First Line : 1345 RXR PLZ
Second Line :
City : UNIONDALE
State : NY
Zip : 11556-1301
Country : US
Telephone Number : 516-783-4600
Fax Number :
Provider Business Practice Location Address
First Line : 852 ROUTE 3
Second Line :
City : CLIFTON
State : NJ
Zip : 07012-2343
Country : US
Telephone Number : 973-450-1991
Fax Number :
Authorized Official
Title or Position : VP, CREDENTIALING
Name : MARLENA SIMPSON
Credential : CPMSM
Telephone Number : 516-453-0435
Provider Enumeration Date : 09/14/2015
Last Update Date : 02/19/2019

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Directions to “CITY MEDICAL OF NEW JERSEY, PC ” Practice Location

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