Healthcare Provider Details

I. General information

NPI: 1215260427
Provider Name (Legal Business Name): UNIVERSAL MEDICAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2009
Last Update Date: 09/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

883 SCHYULER AVE, # 23
KEARNY NJ
07032-4236
US

IV. Provider business mailing address

883 SCHYULER AVE, # 23
KEARNY NJ
07032-4236
US

V. Phone/Fax

Practice location:
  • Phone: 201-800-1416
  • Fax:
Mailing address:
  • Phone: 201-800-1416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number600978
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number600978
License Number StateNY

VIII. Authorized Official

Name: NATALIA BROKOVICH
Title or Position: OWNER
Credential:
Phone: 201-800-1416