Healthcare Provider Details

I. General information

NPI: 1720405368
Provider Name (Legal Business Name): BROOKLYN URGENT MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2014
Last Update Date: 03/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 DRIGGS AVE
BROOKLYN NY
11211-6993
US

IV. Provider business mailing address

633 DRIGGS AVE
BROOKLYN NY
11211-6993
US

V. Phone/Fax

Practice location:
  • Phone: 212-242-4333
  • Fax: 212-242-4389
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number205420
License Number StateNY

VIII. Authorized Official

Name: DR. PATRICK P KO
Title or Position: EMERGENCY MEDICINE
Credential: M.D.
Phone: 212-242-4333