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General NPI Number Information
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NPI Number | 1326442229
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Entity Type | Organization
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Legal Business Name | NORTHEAST URGENT CARE MEDICAL ASSOCIATE
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Dates
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Enumeration Date | 10/21/2014
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Last Update Date | 11/02/2017
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Provider Practice Location Address
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Address Line | 388 TARRYTOWN RD
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City | WHITE PLAINS
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State | NY
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Zip | 10607-1465
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Country | US
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Telephone | 914-777-2273
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Fax | 877-932-7426
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Provider Business Mailing Address
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Address Line | 388 TARRYTOWN RD
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City | WHITE PLAINS
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State | NY
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Zip | 10607-1465
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Country | US
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Telephone | 914-777-2273
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Fax | 877-932-7426
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | DR. JASON B LUPOW
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Credential | M.D.
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Telephone | 914-777-2273
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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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