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General NPI Number Information
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NPI Number | 1245605849
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Entity Type | Organization
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Legal Business Name | L.I.C. URGENT MEDICAL CARE P.C.
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Dates
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Enumeration Date | 12/08/2015
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 535 50TH AVE
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-5967
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Country | US
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Telephone | 646-781-9440
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Fax |
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Provider Business Mailing Address
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Address Line | 110 W 14TH ST
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City | NEW YORK
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State | NY
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Zip | 10011-7303
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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 | PRESIDENT
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Name | PATRICK KO
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Credential | MD
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Telephone | 646-781-9440
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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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