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NPI Code Detail

MEDICARE: URGENT SURGICAL CARE, PLLC

MEDICARE: URGENT SURGICAL CARE, PLLC
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
1163WS0121XPlastic Surgery Registered Nurse
2208200000XPlastic Surgery Physician
32086S0102XSurgical Critical Care Physician
4363AS0400XSurgical Physician Assistant
52086S0122XPlastic and Reconstructive Surgery Physician

General Provider Information

NPI Number : 1437981958
Entity Type Code : Organization
Provider Name (Legal Business Name) : URGENT SURGICAL CARE, PLLC
Provider Business Mailing Address
First Line : 17561 HILLSIDE AVE STE 202
Second Line :
City : JAMAICA
State : NY
Zip : 11432-5771
Country : US
Telephone Number : 929-279-3399
Fax Number :
Provider Business Practice Location Address
First Line : 17561 HILLSIDE AVE STE 202
Second Line :
City : JAMAICA
State : NY
Zip : 11432-5771
Country : US
Telephone Number : 929-279-3399
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. KIMLYN LONG
Credential : MD
Telephone Number : 929-279-3399
Provider Enumeration Date : 08/14/2024
Last Update Date : 08/14/2024

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