Healthcare Provider Details

I. General information

NPI: 1235413477
Provider Name (Legal Business Name): SOUTHERN WESTCHESTER URGENT CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2011
Last Update Date: 10/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915-25 CENTRAL PARK AVE
YONKERS NY
10710
US

IV. Provider business mailing address

484 TEMPLE HILL RD SUITE 104
NEW WINDSOR NY
12553-5557
US

V. Phone/Fax

Practice location:
  • Phone: 914-793-2273
  • Fax:
Mailing address:
  • Phone: 845-565-3700
  • 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: ANTHONY R RUVO
Title or Position: AUTHORIZED MEMBER
Credential: MD
Phone: 845-565-3700