Healthcare Provider Details

I. General information

NPI: 1750151999
Provider Name (Legal Business Name): ESSENTIAL CARE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 UNION ST STE 1B
FLUSHING NY
11354-5513
US

IV. Provider business mailing address

1026 E 212TH ST APT 1
BRONX NY
10469-1315
US

V. Phone/Fax

Practice location:
  • Phone: 347-768-7675
  • Fax:
Mailing address:
  • Phone: 347-768-7675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ASHLEY TABI
Title or Position: PRESIDENT
Credential: MD
Phone: 347-768-7675