Healthcare Provider Details
I. General information
NPI: 1376297119
Provider Name (Legal Business Name): MOBILE MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/10/2022
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
685 3RD AVE FL 9
NEW YORK NY
10017-4151
US
IV. Provider business mailing address
685 3RD AVE FL 9
NEW YORK NY
10017-4151
US
V. Phone/Fax
- Phone: 844-443-6246
- Fax: 833-907-2235
- Phone: 844-443-6246
- Fax: 833-907-2235
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
MBONYE
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 844-443-6246