Healthcare Provider Details

I. General information

NPI: 1255633459
Provider Name (Legal Business Name): ADVANCED URGENT CARE OF SINKING SPRING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2010
Last Update Date: 03/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4631 W PENN AVE
SINKING SPRING PA
19608-9707
US

IV. Provider business mailing address

305 MULBERRY ST
SCRANTON PA
18503-1230
US

V. Phone/Fax

Practice location:
  • Phone: 610-898-4984
  • Fax: 610-898-4998
Mailing address:
  • Phone: 570-909-9989
  • Fax: 866-691-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. MEHDI NIKPARVARFARD
Title or Position: OWNER
Credential: MD
Phone: 570-441-4267