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General NPI Number Information
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NPI Number | 1760659015
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Entity Type | Organization
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Legal Business Name | EXPRESS PEDIATRICS: WALK IN URGENT CARE FOR CHILDREN, PLLC
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Dates
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Enumeration Date | 05/14/2008
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Last Update Date | 06/11/2012
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Provider Practice Location Address
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Address Line | 1989 ROUTE 52 SUITE 3
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City | HOPEWELL JUNCTION
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State | NY
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Zip | 12533-3533
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Country | US
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Telephone | 845-897-4500
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Fax | 845-897-4550
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Provider Business Mailing Address
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Address Line | 1989 ROUTE 52 SUITE 3
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City | HOPEWELL JUNCTION
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State | NY
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Zip | 12533-3533
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Country | US
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Telephone | 845-897-4500
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Fax | 845-897-4550
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Authorized Official
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Title or Position | OWNER, DIRECTOR
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Name | DR. ANNIE MIRANDA
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Credential | MD, PHD
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Telephone | 914-393-7156
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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 | 210185
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License Number State | NY
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