Healthcare Provider Details

I. General information

NPI: 1619016854
Provider Name (Legal Business Name): UPTOWN PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 PARK AVENUE
NEW YORK NY
10128-1735
US

IV. Provider business mailing address

1245 PARK AVENUE
NEW YORK NY
10128-1735
US

V. Phone/Fax

Practice location:
  • Phone: 212-427-0540
  • Fax: 212-534-1086
Mailing address:
  • Phone: 212-427-0540
  • Fax: 212-534-1086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RAMON J. MURPHY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 212-427-0540