Healthcare Provider Details

I. General information

NPI: 1457595118
Provider Name (Legal Business Name): EMILY ANNE URBINA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY ANNE CRUZ URBINA M.D.

II. Dates (important events)

Enumeration Date: 04/25/2009
Last Update Date: 06/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 OLD SHORT HILLS RD APT 374
WEST ORANGE NJ
07052-1040
US

IV. Provider business mailing address

928 BROADWAY STE 803
NEW YORK NY
10010-8125
US

V. Phone/Fax

Practice location:
  • Phone: 561-598-9834
  • Fax:
Mailing address:
  • Phone: 917-922-6455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number265236
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: