Healthcare Provider Details

I. General information

NPI: 1285158014
Provider Name (Legal Business Name): CITY MEDICAL OF NEW JERSEY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2017
Last Update Date: 09/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 N FRANKLIN TPKE
RAMSEY NJ
07446-2823
US

IV. Provider business mailing address

1345 RXR PLZ
UNIONDALE NY
11556-1301
US

V. Phone/Fax

Practice location:
  • Phone: 551-497-5679
  • Fax: 551-497-5680
Mailing address:
  • Phone: 516-783-4600
  • Fax: 646-846-3283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD PARK
Title or Position: CEO
Credential: MD
Phone: 516-783-4600