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General NPI Number Information
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NPI Number | 1568518611
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Entity Type | Organization
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Legal Business Name | URBAN HEALTH PLAN, INC
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 1515 SOUTHERN BOULEVARD
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City | BRONX
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State | NY
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Zip | 10460-5980
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Country | US
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Telephone | 718-589-2440
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Fax | 718-589-4793
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Provider Business Mailing Address
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Address Line | 1065 SOUTHERN BLVD
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City | BRONX
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State | NY
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Zip | 10459-2417
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Country | US
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Telephone | 718-589-2440
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Fax |
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Authorized Official
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Title or Position | CMO/VP MEDICAL AFFAIRS
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Name | DR. SAMUEL DELEON
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Credential | MD
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Telephone | 718-589-2440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | NY
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