Healthcare Provider Details

I. General information

NPI: 1447947767
Provider Name (Legal Business Name): U.S. MOBILE MEDICAL CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 WALL ST FL 20
NEW YORK NY
10005-2123
US

IV. Provider business mailing address

14 WALL ST FL 20
NEW YORK NY
10005-2123
US

V. Phone/Fax

Practice location:
  • Phone: 347-298-4100
  • Fax: 347-227-1368
Mailing address:
  • Phone: 347-298-4100
  • Fax: 347-227-1368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. JONA JANE TAJONERA
Title or Position: CEO
Credential:
Phone: 347-298-4100