Healthcare Provider Details

I. General information

NPI: 1659615870
Provider Name (Legal Business Name): URBAN PEDIATRICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 11/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 HILLVIEW CT
ARMONK NY
10504-1135
US

IV. Provider business mailing address

6 HILLVIEW CT
ARMONK NY
10504-1135
US

V. Phone/Fax

Practice location:
  • Phone: 914-815-7751
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number226404
License Number StateNY

VIII. Authorized Official

Name: MICHELLE ANNE JINDAL
Title or Position: CEO
Credential: MD
Phone: 914-815-7751