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General NPI Number Information
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NPI Number | 1073996211
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Entity Type | Organization
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Legal Business Name | URGENT CARE MEDICAL, P.C.
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 11201 75TH AVE
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City | FOREST HILLS
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State | NY
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Zip | 11375-5633
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Country | US
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Telephone | 718-268-6808
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Fax | 718-268-6858
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Provider Business Mailing Address
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Address Line | 11201 75TH AVE
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City | FOREST HILLS
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State | NY
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Zip | 11375-5633
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Country | US
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Telephone | 718-268-6808
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Fax | 718-268-6858
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. WAIHO LUM
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Credential | MD
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Telephone | 718-268-6808
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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 | 202905
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License Number State | NY
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