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General NPI Number Information
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NPI Number | 1083082069
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Entity Type | Organization
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Legal Business Name | MONTAGUE URGENT MEDICAL CARE P.C
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 109 MONTAGUE ST
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City | BROOKLYN
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State | NY
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Zip | 11201-3437
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Country | US
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Telephone | 212-242-4333
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Fax | 212-242-4389
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Provider Business Mailing Address
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Address Line | 109 MONTAGUE ST
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City | BROOKLYN
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State | NY
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Zip | 11201-3437
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Country | US
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Telephone | 212-242-4333
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Fax | 212-242-4389
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Authorized Official
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Title or Position | M.D
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Name | DR. PATRICK P KO
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Credential | M.D
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Telephone | 212-242-4333
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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 | 205420
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License Number State | NY
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