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General NPI Number Information
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NPI Number | 1033536297
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Entity Type | Organization
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Legal Business Name | NORTH SHORE LIJ MEDICAL GROUP URGENT MEDICAL CARE, P.C
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Dates
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Enumeration Date | 03/26/2014
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 145 COMMUNITY DR
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City | GREAT NECK
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State | NY
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Zip | 11021-5502
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Country | US
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Telephone | 516-253-2844
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Fax |
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Provider Business Mailing Address
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Address Line | 5555 GLENRIDGE CONNECTOR STE 700
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City | ATLANTA
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State | GA
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Zip | 30342-4758
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Country | US
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Telephone | 678-279-2917
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Fax |
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Authorized Official
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Title or Position | VP REVENUE CYCLE
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Name | MELISSA R WILLIS
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Credential |
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Telephone | 678-279-2917
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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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