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General NPI Number Information
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NPI Number | 1659535581
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Entity Type | Organization
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Legal Business Name | UPG HEALTHCARE INC
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 584 FOREST AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10310-2512
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Country | US
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Telephone | 718-226-5603
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Fax | 718-447-6544
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Provider Business Mailing Address
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Address Line | ONE EDGEWATER PLAZA SUITE 704
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City | STATEN ISLAND
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State | NY
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Zip | 10305-4900
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Country | US
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Telephone | 718-226-1036
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Fax | 718-226-1040
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. ALBERT ESPOSITO
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Credential |
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Telephone | 718-226-1036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 7004212R
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License Number State | NY
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