MEDICARE: COMMUNITY URGENT CARE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1295001576
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY URGENT CARE PC

Provider Business Mailing Address
First Line	:	4403 15TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1604
Country	:	US
Telephone Number	:	718-373-1000
Fax Number	:	718-966-2835

Provider Business Practice Location Address
First Line	:	1530 43RD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1605
Country	:	US
Telephone Number	:	718-851-3000
Fax Number	:	718-966-2835

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. ASHLEY TERRONE
Credential	:
Telephone Number	:	929-564-8160

Provider Enumeration Date	:	03/30/2012
Last Update Date	:	03/22/2023

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