Healthcare Provider Details

I. General information

NPI: 1295001576
Provider Name (Legal Business Name): COMMUNITY URGENT CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 43RD ST
BROOKLYN NY
11219-1605
US

IV. Provider business mailing address

4403 15TH AVE
BROOKLYN NY
11219-1604
US

V. Phone/Fax

Practice location:
  • Phone: 718-851-3000
  • Fax: 718-966-2835
Mailing address:
  • Phone: 718-373-1000
  • Fax: 718-966-2835

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. ASHLEY TERRONE
Title or Position: DIRECTOR
Credential:
Phone: 929-564-8160