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NPI Code Detail

MEDICARE: CITY MEDICAL OF UPPER EAST SIDE, PLLC

MEDICARE: CITY MEDICAL OF UPPER EAST SIDE, PLLC
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 : 1992126247
Entity Type Code : Organization
Provider Name (Legal Business Name) : CITY MEDICAL OF UPPER EAST SIDE, PLLC
Provider Business Mailing Address
First Line : 1345 AVENUE OF THE AMERICAS FL 8
Second Line :
City : NEW YORK
State : NY
Zip : 10105-0018
Country : US
Telephone Number : 908-588-3635
Fax Number :
Provider Business Practice Location Address
First Line : 8712 4TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-5110
Country : US
Telephone Number : 516-783-4600
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF PAYMENT SOLUTIONS
Name : SWAHILI HENRY
Credential :
Telephone Number : 908-988-0428
Provider Enumeration Date : 01/03/2014
Last Update Date : 03/03/2025

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