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General NPI Number Information
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NPI Number | 1497576946
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Entity Type | Organization
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Legal Business Name | URBANE CARE NP, NURSE PRACTITIONER IN FAMILY HEALTH, PLLC.
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 420 SOUTH AVENUE 2ND FLOOR, EX SUITES, SUITE 125
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City | STATEN ISLAND
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State | NY
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Zip | 10303
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Country | US
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Telephone | 929-367-0510
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Fax | 929-367-0511
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Provider Business Mailing Address
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Address Line | 42 AMITY PL
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City | STATEN ISLAND
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State | NY
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Zip | 10303-1713
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Country | US
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Telephone | 929-367-0510
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Fax | 929-367-0511
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Authorized Official
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Title or Position | FAMILY HEALTH NURSE PRACTITIONER
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Name | OMOTARA ADEWALE
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Credential | DNP, NP-C, FNP-BC
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Telephone | 646-465-4656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) 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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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