Healthcare Provider Details

I. General information

NPI: 1477929164
Provider Name (Legal Business Name): CROWN HEIGHTS URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2015
Last Update Date: 08/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 LEFFERTS AVE
BROOKLYN NY
11225-4543
US

IV. Provider business mailing address

555 LEFFERTS AVE
BROOKLYN NY
11225-4543
US

V. Phone/Fax

Practice location:
  • Phone: 718-575-0974
  • Fax:
Mailing address:
  • Phone: 718-575-0974
  • 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: ARTHUR KORNBLIT
Title or Position: MEDICAL DOCTOR,OWNER
Credential: MD
Phone: 718-480-6700