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General NPI Number Information
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NPI Number | 1043898729
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Entity Type | Organization
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Legal Business Name | RALPH AVE URGENT CARE
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Dates
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Enumeration Date | 04/01/2021
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Last Update Date | 04/01/2021
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Provider Practice Location Address
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Address Line | 3209 MILBURN AVE
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City | BALDWIN
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State | NY
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Zip | 11510-4932
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Country | US
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Telephone | 516-867-6868
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Fax |
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Provider Business Mailing Address
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Address Line | 402 OCEANFRONT
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City | LONG BEACH
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State | NY
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Zip | 11561-3100
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MED DIRECTOR
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Name | ARTHUR KORNBLIT
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Credential | MD
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Telephone | 516-376-2453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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