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General NPI Number Information
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NPI Number | 1003182924
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Entity Type | Organization
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Legal Business Name | NORTHEAST URGENT CARE MEDICAL ASSOCIATES, PLLC
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Dates
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Enumeration Date | 03/25/2012
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1030 W BOSTON POST RD SUITE A
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City | MAMARONECK
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State | NY
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Zip | 10543-3328
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Country | US
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Telephone | 914-777-2273
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Fax | 877-932-7426
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Provider Business Mailing Address
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Address Line | 1030 W BOSTON POST RD SUITE A
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City | MAMARONECK
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State | NY
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Zip | 10543-3328
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Country | US
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Telephone | 914-777-2273
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Fax | 877-932-7426
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Authorized Official
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Title or Position | PARTNER
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Name | DR. JASON LUPOW
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Credential | MD
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Telephone | 917-704-3356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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