Healthcare Provider Details

I. General information

NPI: 1164594099
Provider Name (Legal Business Name): URBAN FAMILY PRACTICE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

564 NIAGARA STREET
BUFFALO NY
14201
US

IV. Provider business mailing address

564 NIAGARA ST BLDG 2
BUFFALO NY
14201-1108
US

V. Phone/Fax

Practice location:
  • Phone: 716-882-0366
  • Fax: 716-884-8096
Mailing address:
  • Phone: 716-882-0366
  • Fax: 716-306-4177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PT0002X
TaxonomyMedical Toxicology (Emergency Medicine) Physician
License Number1850521NYS
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF332631
License Number StateNY
# 6
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. RODNEY C ARMSTEAD
Title or Position: PRESIDENT
Credential: MD
Phone: 310-418-7250