Healthcare Provider Details

I. General information

NPI: 1528707239
Provider Name (Legal Business Name): URICK MICHEL NP IN FAMILY HEALTH ADULT HEALTH & PSYCHIATRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2022
Last Update Date: 06/01/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1088 RUSSELL ST
FRANKLIN SQUARE NY
11010-2604
US

IV. Provider business mailing address

1088 RUSSELL ST
FRANKLIN SQUARE NY
11010-2604
US

V. Phone/Fax

Practice location:
  • Phone: 917-572-8632
  • Fax:
Mailing address:
  • Phone: 917-572-8632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: URICK MICHEL
Title or Position: OWNER/CEO
Credential: NP
Phone: 917-572-8632