Healthcare Provider Details

I. General information

NPI: 1619373214
Provider Name (Legal Business Name): AI MEDICAL URGENT CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2014
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 BELMONT AVE
BROOKLYN NY
11212-6719
US

IV. Provider business mailing address

70 OLD WESTBURY RD
OLD WESTBURY NY
11568-1611
US

V. Phone/Fax

Practice location:
  • Phone: 718-395-6444
  • Fax: 718-676-9557
Mailing address:
  • Phone: 718-395-6444
  • Fax: 718-676-9557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number247775-1
License Number StateNY

VIII. Authorized Official

Name: DR. IJAZ AHMAD
Title or Position: OWNER/SOLE MEMBER
Credential: M.D.
Phone: 718-789-4333