Healthcare Provider Details

I. General information

NPI: 1083017891
Provider Name (Legal Business Name): URBAN EVALUATION SOLUTION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2014
Last Update Date: 11/15/2022
Certification Date: 11/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2482 BEAUMONT AVE
BRONX NY
10458
US

IV. Provider business mailing address

8 LOMBARDY ST STE 110
NEWARK NJ
07102-3210
US

V. Phone/Fax

Practice location:
  • Phone: 718-915-6443
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ETHEL MORAN
Title or Position: CEO
Credential: MPA
Phone: 201-500-9755