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NPI 1053787960

NPI 1053787960 : ROOSEVELT ISLAND URGENT CARE PLLC : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1053787960
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    Entity Type          |    Organization 
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    Legal Business Name  |    ROOSEVELT ISLAND URGENT CARE PLLC 
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Dates
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    Enumeration Date     |    08/14/2015
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    Last Update Date     |    08/14/2015
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Provider Practice Location Address
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    Address Line         |    520 MAIN ST 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10044-0032
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    Country              |    US
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    Telephone            |    718-575-0974
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    520 MAIN ST 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10044-0032
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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    |    OWNER
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    Name                 |     ARTHUR  KORNBLIT 
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    Credential           |    MD
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    Telephone            |    718-575-0974
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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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