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NPI Code Detail

MEDICARE: URBAN HEALTH PLAN, INC.

MEDICARE: URBAN HEALTH PLAN, INC.
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
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1386247542
Entity Type Code : Organization
Provider Name (Legal Business Name) : URBAN HEALTH PLAN, INC.
Provider Business Mailing Address
First Line : 858-866 EAST TREAMONT AVENUE
Second Line :
City : BRONX
State : NY
Zip : 10460
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 858-866 EAST TREAMONT AVENUE
Second Line :
City : BRONX
State : NY
Zip : 10460-1046
Country : US
Telephone Number : 718-589-2440
Fax Number :
Authorized Official
Title or Position : PRESIDENT AND CEO
Name : PALOMA HERNANDEZ
Credential : PHD
Telephone Number : 718-589-2440
Provider Enumeration Date : 11/19/2020
Last Update Date : 11/19/2020

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