Healthcare Provider Details

I. General information

NPI: 1437518065
Provider Name (Legal Business Name): KARINA URBAEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2016
Last Update Date: 02/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3238 97TH ST
EAST ELMHURST NY
11369-1810
US

IV. Provider business mailing address

3238 97 STREET
EAST ELMHURST NY
11369
US

V. Phone/Fax

Practice location:
  • Phone: 718-416-5330
  • Fax:
Mailing address:
  • Phone: 718-416-5330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: