Healthcare Provider Details

I. General information

NPI: 1114754603
Provider Name (Legal Business Name): EMERGE MEDSTAFFING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22414 MERRICK BLVD STE A
LAURELTON NY
11413-2023
US

IV. Provider business mailing address

22414 MERRICK BLVD STE A
LAURELTON NY
11413-2023
US

V. Phone/Fax

Practice location:
  • Phone: 718-949-6433
  • Fax:
Mailing address:
  • Phone: 718-949-6433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RICHARD WATSON
Title or Position: OWNER
Credential:
Phone: 708-887-8110