Healthcare Provider Details

I. General information

NPI: 1700222353
Provider Name (Legal Business Name): URBAN NEW YORK MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2013
Last Update Date: 08/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2818 STEINWAY ST
ASTORIA NY
11103-3349
US

IV. Provider business mailing address

PO BOX 720507
JACKSON HEIGHTS NY
11372-0507
US

V. Phone/Fax

Practice location:
  • Phone: 718-360-0907
  • Fax: 313-281-8290
Mailing address:
  • Phone: 718-360-0907
  • Fax:

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: MS. SHIRLEY A. ROBINSON
Title or Position: ADMINISTRATION
Credential: ADMINISTRATOR
Phone: 718-360-0907