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General NPI Number Information
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NPI Number | 1437570256
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Entity Type | Organization
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Legal Business Name | URBAN MEDICAL GROUP, PLLC
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Dates
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Enumeration Date | 12/20/2013
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Last Update Date | 12/23/2013
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Provider Practice Location Address
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Address Line | 128 MOTT ST SUITE 202
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City | NEW YORK
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State | NY
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Zip | 10013-5540
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Country | US
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Telephone | 646-355-3711
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Fax | 212-300-4989
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Provider Business Mailing Address
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Address Line | 128 MOTT ST SUITE 202
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City | NEW YORK
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State | NY
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Zip | 10013-5540
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Country | US
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Telephone | 646-355-3711
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Fax | 212-300-4989
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Authorized Official
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Title or Position | MD
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Name | DR. TIMOTHY JOHNSON
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Credential | MD
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Telephone | 646-355-3711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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