Healthcare Provider Details

I. General information

NPI: 1679185904
Provider Name (Legal Business Name): MOBILE MEDICAL HEALTHCARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2020
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

Practice location:
  • Phone: 844-443-6246
  • Fax: 833-907-2235
Mailing address:
  • Phone: 844-443-6246
  • Fax: 833-907-2235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT MBONYE
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 585-278-0502