MEDICARE: COLOMBUS URGENT CARE 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
1	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01118975	OTHER		AMERIGROUP

General Provider Information

NPI Number	:	1659879088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLOMBUS URGENT CARE PC

Provider Business Mailing Address
First Line	:	350 BLOOMFIELD AVE STE 4
Second Line	:
City	:	BLOOMFIELD
State	:	NJ
Zip	:	07003-4852
Country	:	US
Telephone Number	:	973-748-9330
Fax Number	:	973-748-6985

Provider Business Practice Location Address
First Line	:	3235 JOHN F KENNEDY BLVD
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-3405
Country	:	US
Telephone Number	:	908-688-4424
Fax Number	:	973-748-6985

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PRANAY J BHATT
Credential	:	MD
Telephone Number	:	908-688-4424

Provider Enumeration Date	:	01/31/2018
Last Update Date	:	12/16/2022

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Directions to “COLOMBUS URGENT CARE PC ” Practice Location

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